Marginal Food Security Research Articles

Food Insecurity Is Associated with Higher Added Sugar and Sugar-Sweetened Beverage Intake Among Low-Income Elementary Aged Children (P04-059-19)

ObjectivesFood insecurity is adversely associated with physical and mental health and wellbeing in children. The mechanism that underlies this association is assumed to be dietary intake; however, evidence linking food insecurity to child dietary intake has been mixed. This study examined the relationship between self-reported food insecurity and dietary intake among low-income 7–12 year old children. MethodsCross-sectional data were used from TX Sprouts, a school-based cooking, gardening, and nutrition intervention in 16 central Texas schools. A sample of 680 children completed two 24-hour dietary recalls (24hDR) and a questionnaire that included an adapted version of the 5-item Child Food Security Assessment (CFSA). Four ordinal groups, High Food Security (HFS), Marginal Food Security (MFS), Low Food Security (LFS), and Very Low Food Security (VLFS), were generated based on summed scores from the CFSA. The Health Eating Index-2015 and dietary components (total energy, macronutrients, and servings of fruits, vegetables, whole grains, and sugar-sweetened beverages (SSBs)) were derived from 24hDR. Multivariate linear regression models were used to examine the associations between food security and dietary outcomes. A priori covariates included sex, age, ethnicity, and daily energy. ResultsChildren in the study were 45% male, 54% Hispanic, and had an average age of 9.3 years. Main effects of food security were significant for added sugar (P < 0.03) and SSBs (P < 0.04). Compared to children with HFS (referent), those who were LFS and VLFS consumed more added sugar (33.2 g vs. 39.9 g and 40.6 g, P < 0.03 and P < 0.003; respectively). Compared to the HFS referent group, those who were MFS and VLFS had higher mean intakes of SSBs (0.6 vs. 0.8 and 0.9 servings, P < 0.03 and P < 0.01; respectively). There were no significant associations between food security and other dietary outcomes. ConclusionsSelf-reported food insecurity among children (7–12 years of age) was associated with higher added sugar and SSB intake. Future research should assess if the positive association between food insecurity and added sugar and SSB intake contributes to adverse health outcomes. Funding SourcesThis study was supported by funding from the National Institutes of Health, National Heart, Lung, and Blood Institute (NHLBI).

Infants from Food Insecure Households Have Altered Gut Microbiota (OR01-03-19)

ObjectivesInfancy represents a critical period for growth and development. Food insecurity (defined as the limited availability of nutritionally adequate and safe foods) in early life may have both immediate and long-term health implications. Some limited evidence suggests that food insecurity in adults may influence the gut microbiota composition, perhaps through a lack of dietary diversity. A number of studies also link malnutrition with alterations in the gut microbiota in children. However, associations between food insecurity and the gut microbiota have yet to be explored in children and especially in infants, who may have had little exposure to foods other than human milk and formula. MethodsParticipants were from the Nurture study, a birth cohort of predominately black women and their infants residing in the southeastern United States. We collected stool samples from 68 infants 3 months after birth. Our exposure was household food security status assessed when infants were between 2 and 3 months. We used the US Household Food Security Survey Module: Six-Item Short Form. We grouped scores of 0–1 (full or marginal food security) as food secure and 2–6 (low or very low food security) as food insecure, consistent with prior studies. For the 3-month outcome, we used an Illumina MiSeq to conduct paired-end sequencing of the 16S rRNA V4 region. We used beta-binomial regression to determine differential abundance of microbiota according to food security status. Two-sided FDR corrected P-values < 0.05 were considered significant. We adjusted for delivery method (C-section versus vaginal), breastfeeding (never versus any), and timing of introduction to solid foods (at or before 3 months versus after 3 months of age). ResultsDemographic characteristics of mothers and infants from food insecure households (n = 20) resembled those from food secure households (n = 45). The relative abundance of 16 microbial amplicon sequence variants were lower in food insecure infants, and 3 microbial amplicon sequence variants were higher in food secure infants (Figure). ConclusionsFindings from our birth cohort suggest that infants from food insecure households had altered gut microbiota composition at 3 months of age. Future research is warranted to provide mechanistic insight into these potentially novel associations. Funding SourcesNIDDK, National Institutes of Health. Supporting Tables, Images and/or Graphs▪

Household Food Insecurity Is Associated with Higher BMI in a US Cohort of Infants (OR02-03-19)

ObjectivesInfancy represents a critical period for growth and development, and food insecurity during this time may impact later health. Few previous studies have assessed food insecurity and obesity in young children in the US, and even fewer have targeted infants. Moreover, the ability of federal food assistance programs to affect this relation remains unclear. MethodsWe examined 666 infants in the US-based Nurture birth cohort. We conducted home visits when infants were 3, 6, 9, and 12 months. We measured household food insecurity via maternal report using the US Household Food Security Survey Module: Six-Item Short Form. We categorized infants as living in full, marginal, low, or very low food security households. We calculated infant body mass index (BMI) z-score from measured lengths and weights using World Health Organization reference standards. We documented participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and Supplemental Nutrition Assistance Program (SNAP) at each home visit. We used repeated-measures linear regression models with imputed data to examine covariate-adjusted associations between household food security and BMI z-score throughout infancy. ResultsNearly 70% of infants were black and 49% were female. At 3 months, 32.8% of infants were from households with low or very low food security. Infant BMI increased from months 3 to 12 in all food security groups (Figure). However, after adjustment for potential confounders, low household food insecurity (0.18; 95% CI 0.05, 0.32; P = 0.01) and very low household food insecurity (0.22; 95% CI 0.05, 0.38; P = 0.01) were associated with higher infant BMI z-score throughout infancy but marginal household food security was not (0.001; 95% CI −0.13, 0.13; P = 0.99). There was no evidence of effect modification by participation in either WIC (P = 0.36) or SNAP (P = 0.67). ConclusionsInfants from food insecure households had higher BMIs throughout infancy, and this association was not attenuated by WIC or SNAP participation. About one-third of infants in this cohort were living in food insecure households, which raises substantial concern from both a public health and obesity prevention perspective. Funding SourcesNIDDK, National Institutes of Health. Supporting Tables, Images and/or Graphs▪

Food Security Status Among College Students Is Associated with Self-Rated Health, Weight Status, and Dietary Behaviors (P04-083-19)

ObjectivesThe objective of this study was to examine the association between food security status and health and diet-related outcomes in UNC Chapel Hill students. MethodsWe conducted a cross-sectional analysis using data from 4984 students who completed an online questionnaire that was sent to all UNC Chapel Hill students with a publicly available email address in October and November of 2016. The questionnaire assessed food security status over the past 12 months using the 10-item US Adult Food Security Survey Module and included questions related to self-rated health, weight status, and coping strategies related to obtaining food that could impact diet quality. We used multinomial logistic regression to assess the association between food security status and health and diet-related outcomes. Statistical significance was considered P < .05. ResultsAmong students in our sample, 56% experienced high, 22% marginal, 19% low, and 3% very low food security. Compared with students experiencing high food security, students experiencing marginal, low, and very low food security had a significantly greater odds of reporting lower self-rated health. Students experiencing marginal and low food security had a greater odds of experiencing overweight or obesity compared with students experiencing high food security, however, there were no significant associations between very low food security and weight status. Experiencing marginal, low, or very low food security was also significantly associated with sometimes or often eating more food than normal when food was plentiful; eating less healthy meals to be able to eat more; and purchasing cheap, processed food. ConclusionsOnly slightly more than half of students in our sample reported experiencing high food security. This is especially concerning as we found a lower food security status to be associated with worse outcomes related to self-rated health and weight status, as well as an increased likelihood of using coping strategies to obtain food that contribute to poor dietary intake. Funding SourcesThis study was supported by a University of North Carolina at Chapel Hill Food for All micro-grant.

Food insecurity is associated with higher-than-normal blood serum copper level.

To determine associations between household food security status and risk of Cu toxicity. A population-level cross-sectional study to determine adult household food security status and its relationship with serum total Cu concentration (serum Cu) using multivariable regression models. Adult participants in the US National Health and Nutrition Examination Survey (NHANES) 2011-2014. The NHANES phlebotomy data, a nationally representative sample (n 2780; 1360 men and 1420 women), were analysed. A significantly greater proportion of food-insecure persons had serum Cu that was above the upper value of the normal range (clinical cut-off) compared with their food-secure counterparts. In men, food insecurity (OR = 2·24, P < 0·001) and marginal food security (OR = 1·79, P < 0·001), and in women, marginal food security (OR = 1·82, P = 0·016), associated with greater likelihood to have serum Cu that was above the upper value of the normal range. Food insecurity was significantly associated with greater likelihood (OR = 1·65, P = 0·020) to have serum Cu that was within the upper quartile (≥75th centile). Food-insecure persons associate with higher serum Cu concentration and are at greater risk of Cu toxicity. There is need to study the sources of Cu in general, and specifically in food-insecure persons, to facilitate reduction of Cu exposure. Examining Cu contents of the food and water supplies could explicate any relationships to food insecurity and Cu intake.

Food Security and 10-Year Cardiovascular Disease Risk Among U.S. Adults

Cardiovascular disease is a leading cause of mortality in the U.S. Although the risk of cardiovascular disease can be mitigated substantially by following a healthy lifestyle, adhering to a healthy diet and other healthy behaviors are limited by reduced food security. This study aims to determine the association between food security and cardiovascular disease risk. Three samples from the 2007-2014 National Health and Nutrition Examination Survey were examined: (1) 7,340 non-fasting adults (aged 40-79 years); (2) 13,518 non-fasting adults (aged 20-64 years); and (3) 6,494 fasting adults (aged 20-64 years). Food security was assessed using the U.S. Household Food Security Survey Module, with households categorized as having full, marginal, low, or very low food security. Regressions were conducted in 2018 to test the associations between food security status and odds of ≥20% 10-year cardiovascular disease risk among middle-aged to older adults (OR, 95% CI) and cardiovascular disease risk factors among all adults (β, 95% CI). Compared with adults with full food security, those with very low food security had higher odds of ≥20% 10-year cardiovascular disease risk (OR=2.36, 95% CI=1.25, 4.46), whereas those with marginal food security had higher systolic blood pressure (β=0.94 mmHg, 95% CI=0.09, 1.80). Compared with adults with full food security, adults with different levels of food security had higher BMIs (marginal: 0.76, 95% CI=0.26, 1.26; low: 0.97, 95% CI=0.34, 1.60; and very low: 1.03, 95% CI=0.44, 1.63) and higher odds of current smoking (marginal: OR=1.43, 95% CI=1.17, 1.75; low: OR=1.47, 95% CI=1.22, 1.77; and very low: OR=1.95, 95% CI=1.60, 2.37). Adults with food insecurity have elevated cardiovascular disease risk factors and excess predicted 10-year cardiovascular disease risk. Substantially improving food security may be an important public health intervention to reduce future cardiovascular disease in the U.S.

Assessing the relationship between food insecurity and mortality among U.S. adults

PurposeSignificant evidence supports a relationship between food insecurity and health, but little work has investigated its relationship on all-cause mortality within a high resource country, such as the United States. MethodsData from the 2003–2010 National Health and Nutrition Examination Survey was matched to National Death Index information. Cox models were used to study the relationship between mortality and food insecurity, adjusting for relevant covariates in a sequential manner (demographics, comorbidities, lifestyle variables, body mass index). Food insecurity was used as dichotomous and as four categories. ResultsOf 20,918 participants, 11.6% (representing 208,789,244 U.S. residents) were food insecure. When food insecurity was dichotomized, there was 49% higher odds of mortality after adjusting for demographics (HR, 1.49; 95% CI, 1.19–1.87). After adjusting for comorbidities, the HR remained significant, but lost significance with adjustment for lifestyle factors and body mass index (HR, 1.15; 95% CI, 0.94–1.42). However, marginal food security lost significance after adjustment for lifestyle variables. ConclusionsFood insecurity significantly impacts all-cause mortality in the United States; however, lifestyle may explain this relationship. Interventions should account for level of severity when creating targeted programs.

Household Food Insecurity and Dietary Saturated Fat in Rural Appalachia

Purpose: To explore the relationship between food insecurity and dietary saturated fat intake in rural Central Appalachia. Design: Cross-sectional analysis of baseline data from a longitudinal interventional studySample: Baseline assessment of dietary saturated fat intake and food security in volunteers who had resided in rural Central Appalachia for at least five years and were enrolled in a cooking skills class.Method: Volunteers (n=56, 89.3% female) completed the USDA Household Food Security Survey Module (HFSSM) and Diet History Questionnaire-II. Average age was 56.5 (range 18-76) years. Average intake of saturated fat was calculated using DietCalc software. Food security was measured using the HFSSM. Descriptive and inferential statistical analyses were conducted using SAS, v. 9.3 with an alpha level of .05.Findings: High or marginal food security was experienced by 75% with 25% of participants experiencing low/very low food security. Average daily saturated fat was 26 grams. Significant findings included greater saturated fat consumption in men; lower saturated fat consumption with older age; older age being associated with lower food insecurity; and no association between food insecurity and saturated fat intake. Average daily saturated fat gram intake was significantly lower for females than males; the group means were 23.6 (SD = 12.4) and 49.6 (SD = 15.0) for these two groups, respectively (t = 4.8, P < .001). For every 10-year increase in age, there was a 2.7 gram decrease in daily saturated fat intake.Conclusions: Historical food traditions and method of food preparation likely contribute to the lack of an association between high food security and saturated fat intake in rural Appalachia. Food insecurity was not associated with saturated fat intake in our sample. Additional research is needed to determine to the full impact of food insecurity on dietary fat intake in Appalachia.Keywords: Food Insecurity, Appalachian Region, Fatty Acids Saturated, Poverty DOI: http://dx.doi.org/10.14574/ojrnhc.v19i1.568 Acknowledgments: This study was funded by the National Institute of Nursing Research Grant 5K23NR014883-02.

Associations between food insecurity and prediabetes in a representative sample of U.S. Adults (NHANES 2005–2014)

AimsThe primary aim of this research was to investigate the association between food insecurity and prediabetes and to identify specific subgroups for early clinical intervention. MethodsCross-sectional data from 25,814 participants were analyzed from the National Health and Nutrition Examination Survey for years 2005–2014. Multivariable logistic regression was used to explore the association between food security status and laboratory-confirmed prediabetes. All models were adjusted for age, sex, race, and body mass index. ResultsWhen compared to participants with full and marginal food security, participants with low/very food security were 1.35 (95% CI: 1.17–1.55) times more likely to have prediabetes. Younger individuals with low/very low food security had a greater likelihood of prediabetes, 1.50 (95% CI: 1.19–1.81), when compared with their food secure counterparts. ConclusionsFood insecurity at any level, whether low or very low, is positively associated with prediabetes in the U.S. general adult population. Food insecure young adults, particularly those aged 20–34 years, should be targeted for early clinical intervention.

Recognition of Federal Dietary Guidance Icons Is Associated with Greater Diet Quality

BackgroundAlthough the purpose of federal dietary guidance is to improve eating habits, few studies have described awareness of guidance and concurrent diet quality. ObjectiveThe objective of the current study was to examine the prevalence of individuals who reported hearing of dietary guidance icons and to describe the association between having heard of the icons and diet quality. DesignThis study was a cross-sectional survey. Participants/settingParticipants (n=23,343) were from the National Health and Nutrition Examination—What We Eat in America survey 2005–2014 cycles. Main outcome measuresAwareness of the Food Guide Pyramid, MyPyramid, or MyPlate icons by sociodemographic characteristics and diet quality were measured using Healthy Eating Index (HEI) scores derived from 24-hour recall data. Statistical analyses performedGlobal Wald tests were used to test for differences in awareness of the icons within sociodemographic groups. Total HEI scores were calculated using the population-ratio method. Z-scores were used to test differences in HEI total scores between those with knowledge of the icons and those who responded negatively. ResultsIn all cycles, those with less than a high school diploma were the least likely to report having heard of the icons (P<0.001). In every wave except 2011 to 2012, participants with low or marginal food security status were less likely to report affirmatively (P<0.001), and Supplemental Nutrition Assistance Program (SNAP) participants and SNAP-eligible nonparticipants were least likely to report having heard of the icons (P<0.001) except for 2005 to 2006. HEI scores were higher among those who had heard of MyPyramid in 2007-2012 (P<0.05) and MyPlate in 2013-2014 (P<0.001) compared with those who had not heard of the icon. ConclusionsRecognition of federal dietary guidance icons was associated with higher diet quality recently, but the cross-sectional nature of the data precludes conclusions of causality. Further research is needed to identify barriers and promoters for translating awareness of the federal dietary guidance icons into healthful food purchasing and food consumption decisions.

Food Insecurity, Financial Shocks, and Financial Coping Strategies among Households with Elementary School Children in Wisconsin

This article examines the associations among food insecurity, financial shocks, and financial coping strategies among elementary school students' households in Wisconsin using a survey of parents. Volatility in income and expenses are predictive of households' ability to meet food needs, and parents who have experienced large or volatile expenses report more difficulty in shielding child(ren) from food hardships. Food insecurity is characterized by a continuum of financial adaptations—ranging from relying on savings, borrowing from family and friends, and increased work effort in conjunction with marginal food security, and progressing toward use of potentially inferior forms of credit such as payday and pawn loans at the more severe end of the food insecurity spectrum. In addition to income‐focused coping strategies, survey respondents report food‐specific coping strategies. Overall, the results suggest that food security and financial security interventions may work in concert and may benefit from greater coordination.

Food Affordability, Food Security, and the Expanded Food and Nutrition Education Program

ABSTRACTThe Expanded Food and Nutrition Education Program’s (EFNEP) focus on healthy dietary practices and resource management targets both healthy eating and food security in low-income populations. A preliminary study with an EFNEP population in the northeast developed and tested food affordability questions (self-reported ability to afford healthy foods, fruits/vegetables, and the same kinds of foods throughout the month, baseline/pre-EFNEP, n = 80) and assessed change in food security pre-/post-EFNEP (USDA 30-day 6-item Food Security Module, n = 68). At baseline, food security was positively related to ability to afford self-identified healthy foods (p = 0.006) and fruits/vegetables (p = 0.038) throughout the month. Full and marginal food security increased from pre-EFNEP (39%) to post-EFNEP (71%, p = 0.022). Self-reported ability to purchase healthy foods throughout the month is related to food security. Nutrition education that targets resource management improves household food security.

Food security among individuals experiencing homelessness and mental illness in the At Home/Chez Soi Trial.

Individuals experiencing homelessness are particularly vulnerable to food insecurity. The At Home/Chez Soi study provides a unique opportunity to first examine baseline levels of food security among homeless individuals with mental illness and second to evaluate the effect of a Housing First (HF) intervention on food security in this population. At Home/Chez Soi was a 2-year randomized controlled trial comparing the effectiveness of HF compared with usual care among homeless adults with mental illness, stratified by level of need for mental health services (high or moderate). Logistic regressions tested baseline associations between food security (US Food Security Survey Module), study site, sociodemographic variables, duration of homelessness, alcohol/substance use, physical health and service utilization. Negative binomial regression determined the impact of the HF intervention on achieving levels of high or marginal food security over an 18-month follow-up period (6 to 24 months). Community settings at five Canadian sites (Moncton, Montreal, Toronto, Winnipeg and Vancouver). Homeless adults with mental illness (n 2148). Approximately 41 % of our sample reported high or marginal food security at baseline, but this figure varied with gender, age, mental health issues and substance use problems. High need participants who received HF were more likely to achieve marginal or high food security than those receiving usual care, but only at the Toronto and Moncton sites. Our large multi-site study demonstrated low levels of food security among homeless experiencing mental illness. HF showed promise for improving food security among participants with high levels of need for mental health services, with notable site differences.

The Association between Food Security and Store-Specific and Overall Food Shopping Behaviors

BackgroundFood security is a severe problem in the United States. Few studies have examined its relationship with food shopping behaviors. ObjectiveThis study aimed to examine the association between food security and store-specific and overall food shopping among residents of low-income neighborhoods. DesignWe conducted a cross-sectional study. Participants/settingFive hundred twenty-seven households were recruited from two counties in South Carolina from November 2013 to May 2014, and 474 households were included in the final analysis. Main outcomes measuresFood security was assessed using the 18-item US-Household Food Security Module questionnaire, and classified into three categories: high or marginal food security (FS), low food security (LFS), and very low food security (VLFS). Store-specific shopping behaviors including frequency, store type, and transportation were queried via in-person interview for the three most-frequented grocery stores. Distance from participants’ homes to their reported stores was calculated using Geographic Information Systems. Statistical analysesMultivariate linear regression for analyses of distance and frequency and multinomial/ordinary logistic regression for analyses of store type and transportation were used. ResultsCompared to FS participants, a significantly higher proportion of VLFS participants reported a convenience/dollar store as their most-frequented store (odds ratio [OR] 2.31, 95% CI 1.08 to 4.95) or a lack of transportation (OR 2.04, 95% CI 1.25 to 3.33). They also shopped less frequently (b=−.31, P=0.03) at their third most-frequented store and traveled fewer total miles for shopping (b=−4.71, P=0.04). In analyses considering all stores jointly, LFS participants had lower odds of shopping at both supermarkets and convenience/dollar stores (OR 0.44, 95% CI 0.21 to 0.91) compared to food-secure residents. ConclusionsThe current findings suggest that households with VLFS tend to shop more frequently in stores that have less-healthful options, such as convenience/dollar stores. These findings lend support to ongoing community and policy interventions aimed at improving food access among food-insecure populations.

Food Security Status for the Household: A Case Study of Al-Qadarif State, Sudan (2016)

Food security is under focused issue in Sudan and Al-Qadarif State is not apart from that. According to the integrated food security phases classification (IPC) report April 2015, about 60% of the population suffering from food insecurity in the state. This problem needs to be solved by a clear and sound policies and strategies. The main objective of this study is to evaluate the food security situation in the state, using a module concerning the demand side and to investigate and evaluate the Food Security and Nutrition (FSN) status in the state. To achieve this objective primary data were collected by the mean of questionnaires targeting house hold (394) sample size has been determined by using the Kerjcie and Morgan table, the household questionnaire was to determine the status of the food security within the state, using the USA. Household Food Security Survey Module: six-item short, and to determine the coping strategies of the household. The main results of this research are that: there only 9% of the households in high or marginal food security situation and the main factors that affecting the household food security status are age and job with significant P value 0.002 and 0.013 respectively. About 60.2% use borrowing from others as one of their coping strategy. Finally, the main recommendation of this study is to build a food security and nutrition policy/strategy putting the natural resources conservation in consideration.

Predictors of college-student food security and fruit and vegetable intake differ by housing type

ABSTRACTObjective: We assessed whether college-student characteristics associate with food security and fruit and vegetable (FV) intake and whether these associations differ in students in housing with and without food provision. Participants: 514 randomly-sampled students from a large, Midwestern, public university in 2012 and 2013 Methods: Ordered logistic regression tested how student characteristics associate with food security. Linear regression tested how student characteristics associate with FV intake. Analyses were stratified by housing type – that is, housing with food provision (dormitory, fraternity/sorority house, cooperative) vs. housing without food provision.Results: Only among those living in housing without food provision, males (p = 0.04), students without car access (p = 0.005), and those with marginal (p = 0.001) or low (p = 0.001) food security demonstrated lower FV intake. Conclusions: Housing with food provision may buffer the effects of student characteristics on food.

Dyslipidemia and Food Security in Low-Income US Adolescents: National Health and Nutrition Examination Survey, 2003-2010.

IntroductionLow levels of food security are associated with dyslipidemia and chronic disease in adults, particularly in women. There is a gap in knowledge about the relationship between food security among youth and dyslipidemia and chronic disease. We investigated the relationship between food security status and dyslipidemia among low-income adolescents.MethodsWe analyzed data from adolescents aged 12 to 18 years (N = 1,072) from households with incomes at or below 200% of the federal poverty level from the National Health and Nutrition Examination Survey (NHANES) 2003–2010. We used logistic regression to examine the relationship between household food security status and the odds of having abnormalities with fasting total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), serum triglycerides (TGs), high-density lipoprotein cholesterol (HDL-C), TG/HDL-C ratio, and apolipoprotein B (Apo B). Models included age, sex, race/ethnicity, smoking status, partnered status in the household, and maternal education, with additional adjustment for adiposity.ResultsHousehold food security status was not associated with elevated TC or LDL-C. Adolescents with marginal food security were more likely than food-secure peers to have elevated TGs (odds ratio [OR] = 1.86; 95% confidence interval [CI], 1.14–3.05), TG/HDL-C ratio (OR = 1.74; 95% CI, 1.11–2.82), and Apo B (OR = 1.98; 95% CI, 1.17–3.36). Female adolescents with marginal food security had greater odds than male adolescents of having low HDL-C (OR = 2.69; 95% CI, 1.14–6.37). No elevated odds of dyslipidemia were found for adolescents with low or very low food security. Adjustment for adiposity did not attenuate estimates.ConclusionIn this nationally representative sample, low-income adolescents living in households with marginal food security had increased odds of having a pattern consistent with atherogenic dyslipidemia, which represents a cardiometabolic burden above their risk from adiposity alone.

Food Insecurity and Eating Behavior Relationships Among Congregate Meal Participants in Georgia

ABSTRACTThis study explored relationships of food insecurity with cognitive restraint, uncontrolled eating, and emotional eating behaviors among congregate meal participants in northeast Georgia [n = 118 years, age 60 years and older, mean (SD) age = 75 (8) years, 75% female, 43% Black, 53% obese (Body Mass Index ≥ 30)]. Food insecurity was assessed with a 6-item questionnaire. Scores ranged from 0 to 6 and were defined as high or marginal food security, FS, 0–1 (70%); low food security, LFS, 2–4 (20%); very low food security, VLFS, 5–6 (10%); and low and very low food security, LVLFS, 2–6 (30%). Eating behavior was assessed with an 18-item Three-Factor Eating Questionnaire R-18. In bivariate analyses food insecurity was consistently associated with cognitive restraint scores above the median split and to a lesser extent with uncontrolled eating scores (p ≤ 0.05). No association was found between emotional eating and food insecurity. In multivariate linear and logistic regression analyses, food insecurity was consistently associated with cognitive restraint (p ≤ 0.05) even when controlled for potential confounders (demographics, Body Mass Index, and chronic diseases). Food insecurity was also associated with uncontrolled eating (p ≤ 0.05), but the relationship was attenuated when controlled for potential confounding variables. Although cognitive restraint is defined as the conscious restriction of food intake to control body weight or promote weight loss, these findings suggest there may be other dimensions of cognitive restraint to consider in nutritional assessment and interventions among food-insecure older adults.

Household food insecurity and medication “scrimping” among US adults with diabetes

ObjectiveOur research examined the prevalence of food insecurity among adults with self-reported diabetes and whether food insecurity was associated with cutting back (“scrimping”) on prescribed medications because of financial constraints. MethodsWe conducted a cross-sectional analysis of data from the 2011 National Health Interview Survey (NHIS). Adults completing this survey were considered to have diabetes if they reported current use of insulin or “diabetic pills” (n=3,242). Food insecurity was determined with a 10-item scale; respondents were categorized as food secure (FS), marginally food secure (MFS) or food insecure (FI). ResultsApproximately one in six adults in NHIS with diabetes reported food insecurity (17.0%), and an additional 8.8% were marginally FS. An individual was considered to be scrimping on medications if he/she gave a “yes” response to at least one of four questions pertaining to reduced, delayed or avoided medication use. Overall, 18.9% of respondents with diabetes reported one or more type of medication scrimping: 11.7% of FS individuals, 27.7% of MFS individuals and 45.6% of FI individuals. In adjusted analyses, marginal food security and food insecurity remained strongly associated with scrimping. ConclusionsOne-quarter of adults with diabetes may have difficulty obtaining foods appropriate for a diabetic diet; a substantial number of these individuals also fail to obtain or take medications. Practitioners may miss either problem unless targeted questions are included in clinical encounters. Clinicians should consider referring FI and MFS diabetic patients to community food resources.

People with diabetes, respiratory, liver or mental disorders, higher urinary antimony, bisphenol A, or pesticides had higher food insecurity: USA NHANES, 2005-2006.

This study was aimed to examine the prevalence of food insecurity and what social, health, and environmental characteristics could constitute such situation in a national and population-based setting. Data was retrieved from the National Health and Nutrition Examination Survey, 2005-2006. Information on demographics, lifestyle factors, self-reported ever medical conditions in the past and self-reported food security conditions in the last 12 months calculated on the household level was obtained by household interview. Bloods and urines (subsample) were collected at the interview as well. Only adults aged 20 years and above (n = 4979) were included for statistical analysis in the present study. Chi-square test, t test, and survey-weighted logistic regression modeling were performed. Three thousand eight hundred thirty-four (77.9%) people were with full food security, 466 (9.5%) people were with marginal food security and 624 (12.7%) people were with low or very low food security. Being younger, having higher ratios of family income to poverty thresholds (due to low level of education or lack of financial support), having prior asthma, arthritis, chronic bronchitis, depression, diabetes, eczema, emphysema or liver problems, having higher levels of serum cotinine, urinary antimony, bisphenol A, pesticides, or having lower levels of urinary Benzophenone-3 were associated with food insecurity. In addition to socioeconomic and smoking conditions, evidence on people with several prior health conditions and being exposed to environmental chemicals and food insecurity is further provided. Future social, health and environmental policy, and programs protecting people from food insecurity by considering both health and environmental factors mentioned above would be suggested.