Prevalence Of FI Research Articles

Estimating the number of Canadians suffering from fecal incontinence using pooled prevalence data from meta-analysis

Background and aimFecal incontinence (FI) is defined as the unintended loss of solid or liquid stool. FI adversely affects the patient’s quality of life. However, due to stigma, lack of awareness, and underdiagnosis, there is a notable gap in the knowledge regarding its prevalence. This study aimed to conduct a systematic review and meta-analysis of published literature reporting on FI prevalence and estimate the number of people afflicted by FI.MethodsA systematic review was conducted following the PRISMA 2020 guidelines, using the Embase, MEDLINE, CINHAL, and PubMed databases to identify relevant publications in the English language. Two reviewers independently screened the articles and extracted data. The reference sections and content of the review papers were also evaluated. Thirty-two articles were selected and included. A meta-analysis of proportions was performed using RStudio software. A sub-analysis was conducted to account for the variation between sample population age groups to minimize heterogeneity. The pooled prevalence was extrapolated to the Canadian population and a sample of ten densely populated countries to estimate the number of people affected by FI.ResultsThe Mean pooled FI prevalence in men and women was 7% (95% CI: 6-9%) and 10% (95% CI: 8-12%), respectively. The sub-analysis mean pooled prevalence of FI in men and women was 8% (95% CI: 6-10%) and 10% (95% CI: 8-12%), respectively. The authors estimate that between 1 and 1.5 million Canadians and 320 to 500 million people in the ten most populous countries suffer from FI.ConclusionFecal incontinence is a prevalent underdiagnosed condition requiring appropriate and timely treatment to improve a patient’s quality of life.

Cross-sectional association of food insecurity with loneliness in older adults: The role of sex, age, and psychosomatic factors

ObjectiveFood insecurity (FI) is a critical social determinant of poor psychosocial health. While data on the specific roles of sex and age in the FI-loneliness link among older adults are limited, the underlying mechanisms are largely unknown. This study examines the age-sex-specific associations of FI with loneliness among older adults in Ghana and quantifies the extent to which psychosomatic factors mediate the association. MethodsWe analyzed cross-sectional data from the Aging, Health, Psychological, and Health-seeking Behavior Study in Ghana. The past 30-day FI was assessed using items on hunger and breakfast skipping frequency due to a lack of resources. We assessed loneliness severity with the University of California, Los Angeles 3-item Loneliness Scale. Multivariable OLS regressions and bootstrapping mediation analysis using the Hayes PROCESS macro plug-in were used to evaluate the associations. ResultsWe included 1,201 individuals aged ≥50 years (mean = 62.9 [SD = 11.9]; women = 63.3%). The prevalence of loneliness was 17.7%. The prevalence of moderate and severe FI was 44.0% and 8.5%, respectively. In the adjusted model, greater FI was significantly associated with loneliness severity (B = .22, SE = .029, p < .001). We found significant interactive effects of FI × age (B = −.17, SE = .023, p < .01) and FI × sex (B = −.28, SE = .036, p < .001) on loneliness. Thus, the FI-loneliness link was respectively more marked among women (B = .25, SE = .035, p < .001) and ≥65 age groups (B = .34, SE = .041, p < .001) than men (B = .16, SE = .051, p < .01) and those aged 50−64 (B = .22; SE = .040, p < .001). Finally, comorbid depression/anxiety (41.07%), hopelessness (48.6%), worthlessness (42.1%), functional limitations (8.2%), and pain severity (6.4%) mediated the FI-loneliness association. ConclusionsAge- and sex-specific associations between FI and loneliness exist among older Ghanaians. Addressing FI in concert with psychosomatic problems in older adults may contribute meaningfully to reducing loneliness in later life.

Food insecurity, inflammation, and immune function among older US adults: Findings from the health and Retirement study

BackgroundFood insecurity (FI) is a pressing public health concern among older adults and has been associated with adverse cardiovascular outcomes. Greater systemic inflammation may provide a pathway to explain these associations, but few studies have examined the link between FI and markers of inflammation. Thus, the objective of the present study was to evaluate the associations between FI and multiple inflammatory and immune functioning biomarkers using a nationally representative study of US adults aged > 50 years. MethodParticipants (n = 3,924) were drawn from the longitudinal Health and Retirement Study (HRS). Household FI was assessed using the six-item Short Form Food Security Survey Module from the 2013 HRS Health Care and Nutrition Study. Markers of inflammation (neutrophil–lymphocyte ratio, albumin, hs-CRP, IL6, IL10, IL-1Ra, sTNFR-1, and TGFβ-1) and immune functioning (CMV) were collected during the 2016 HRS Venous Blood Study. Multivariate logistic and linear regression models were used to evaluate associations between household FI and inflammatory and immune functioning biomarkers, adjusting for individual and household sociodemographic characteristics. ResultsThe weighted prevalence of FI was 18.8 %. Age and sex-adjusted mean showed that FI was associated with higher levels of inflammation and impaired immune functioning (Ps-value < 0.05). Older adults with FI had higher mean levels of albumin, hs-CRP, IL6, IL10, IL-1Ra, TGFß-1, and CMV seronegative and borderline (Ps-value < 0.05). Multivariate-adjusted regression model showed that FI was associated with high-risk categories of hs-CRP (OR 1.34, 95 % CI 1.06, 1.68), IL-6 (OR 1.66, 95 % CI 1.28, 2.14), IL-1Ra (OR 0.67, 95 % CI 0.48, 0.93), TGFß-1 (OR 1.87, 95 % CI 1.45, 2.42), seronegativity for CMV (OR 0.48, 95 % CI 0.35, 0.64). ConclusionIn this nationally representative sample of older adults, FI was positively associated with multiple markers of systemic inflammation and impaired immune functioning. Public health efforts that directly work to reduce FI among older adults are warranted and may result in further improvements in their health and well-being.

1834. Impact of COVID-19 and Socioeconomic Status on Food Insecurity in the US Adult Population: Analysis of the 2021 National Health Interview Survey

Abstract Background Food insecurity (FI) is a public health concern and negatively affects the health and well-being of many adults in the US, which may have been exacerbated since the COVID-19 pandemic. However, the relationship between COVID-19 and FI among US adults has not been elucidated. Methods Data were from the 2021 National Health Interview Survey that used stratified clustering sampling to interview US adults aged ≥ 18 years. COVID-19 infection (yes/no) was per self-report. FI, determined by a 10-item questionnaire assessing household food situations in the past 30 days, was dichotomized (yes/no). Unweighted frequencies and weighted percentages were calculated and compared using Rao-Scott chi-square tests. Multivariable logistic regression was used to examine differences in FI prevalence by COVID-19. All analyses accounted for complex survey design and weights. Results The unweighted sample size was 28,274 (mean age 48.3 years). Overall, 13.5% (95% CI: 13.0%-14.1%) had COVID-19, and 5.9% (95% CI: 5.5%-6.3%) experienced FI. Adults with COVID-19 reported a significantly higher percentage of FI than those without (7.3% [95% CI: 6.1%-8.6%] vs. 5.6% [95% CI: 5.2%-6.0%], p=0.003). Most (63.2%) were White, followed by 16.7% Hispanic, 11.5% Black, 5.9% Asian, and 2.6% other races; 22.6% were on Medicaid/Medicare and 9.8% were uninsured; 12.9% received food stamps in the past 12 months. In the adjusted model, adults with COVID-19 were more likely to have experienced FI than those without (adjusted odds ratio [aOR]=1.29, 95% CI: 1.07-1.56). Black (aOR=2.08, 95% CI: 1.72-2.50) or Hispanic (aOR=1.26, 95% CI: 1.03-1.53) adults were more likely than their White counterparts to have experienced FI. Uninsured adults (aOR=2.67, 95% CI: 2.15-3.31) or those on Medicaid/Medicare (aOR=1.94, 95% CI: 1.60-2.35) had greater odds of having experienced FI than those privately insured. Adults receiving food stamps were more likely to have experienced FI than those not receiving (aOR=2.87, 95% CI: 2.36-3.50). Conclusion In this study of a nationally representative sample, our findings highlight a higher prevalence of FI among adults with COVID-19, with lower socioeconomic status, or in racial/ethnic minority communities and suggest the need for intervention strategies addressing FI in these adult populations. Disclosures All Authors: No reported disclosures

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

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

A UK-wide survey of healthcare professionals' awareness, knowledge and skills of the impact of food insecurity on eating disorder treatment

ObjectiveFood insecurity (FI) is associated with significant adverse effects on health and well-being and increasingly recognised as a global problem. The current study explored the impact of FI on eating disorder (ED) clinical practice in the UK, aiming to assess healthcare professionals' (HCPs) knowledge, skills and views on the topic of FI in their patients. DesignThis study was an exploratory, mixed-methods, descriptive analysis of online survey data collected from ED HCPs in the UK between September and October 2022. MeasuresA 15-item survey with rating and open-ended questions was circulated to ED professional organisations in the UK. Descriptive statistics were used to summarise quantitative data, including perceived prevalence of FI in ED clinical practice and confidence in knowledge on the topic. Descriptive content analyses provided insight into perspectives on FI screening and aspects to be included in guidance and resources. Results93 ED HCPs completed the survey (40.9 % psychologists). Findings demonstrated healthcare providers' limited knowledge on FI and its relation to EDs, while they increasingly perceive it in their patients, as well as a general lack of available resources on how to address FI in ED treatment. HCPs stressed the need for practical guidance and formal training for dealing with FI in their patients, as well as implementing routine screening. ConclusionThese findings provide both important directions for future research and clinical applications related to screening, assessment, treatment and support of food-insecure patients with EDs.

P331 Risk Factors and Prediction Model for Fecal Incontinence in Patients with Crohn’s Disease: A Multicenter Study

Abstract Background Fecal incontinence (FI) is a common complaint that seriously affects the quality of life in patients with Crohn’s disease (CD). We aimed to identify risk factors related to FI and construct a risk prediction model for FI in patients with CD. Methods Four hundred and sixty-one patients diagnosed with CD between June 2016 and April 2021 in Jiangsu Province Hospital of Chinese Medicine were retrospectively enrolled in this study and randomly divided into the development (n=368) and internal validation cohort (n=93). FI-related risk factors were selected from the development cohort using the random forest procedure and included in a logistic regression model from which the prediction model was elaborated. The discrimination, calibration and clinical benefit of the model were evaluated by examining the area under the receiver operating characteristic curves, calibration curves and decision curve analysis in internal validation and external validation (using 225 patients from four tertiary hospitals), respectively. Results Four independent variables were selected and included in the logistic regression model: body mass index, history of non-fistulizing perianal lesions surgery, the number of loose stools in the last week and perianal disease activity index. A nomogram was developed to facilitate risk score calculation. The model showed good discrimination ability with AUC was 0.798 and 0.780 in the internal and external cohorts, respectively. The calibration curves demonstrated good agreement with the model using the Hosmer-Lemeshow test in both cohorts (internal validation, P = 0.562; external validation, P = 0.383). DCA confirmed the clinical validity of the predictive model. Conclusion This study recognized four risk factors related to the prevalence of FI and developed a new model to effectively predict risk scores of FI in CD patients, helping to provide early risk stratification and timely intervention.

Prevalence and factors associated with food insecurity in southern Mozambique

Abstract Background Food insecurity (FI) is one of the major causes of malnutrition in low- and middle-income countries. In Mozambique, the burden of FI and how it’s related to negative health outcomes is unknown. This study aimed to investigate the prevalence of FI as well as the factors associated with FI in southern Mozambique. Methods Preliminary data from 301 household heads residing in suburb and peri-urban districts of Maputo were analysed in a cross-sectional design. Accordingly, FI was assessed using the 8-items of the United States Department of Agriculture Household Food Security Survey Module, and its association with various factors was determined through multiple regression models. Results The prevalence of FI was 62.8% (23.6% of households had mild FI, 16.6% had moderate FI, 22.6% had severe FI). Based on multiple regression models, 10 variables (out of 11) were relevant drivers of FI and reached statistical significance (p-value&amp;lt;0.05) with focus on food diversity, climate change, illnesses, household income, number of meals, type of work, household size. Conclusions These preliminary findings suggest the need for decent work and job creation. In addition, food diversity, climate change and some relevant diseases should be taken into account in the development of public health policies designed to alleviate household food insecurity in Mozambique. Key messages • Food insecurity in Mozambique calls for joint efforts from government, private sector, international institutions and communities. • The basic food basket for the most vulnerable groups is encouraged as a short-term solution.

95 Prevalence and Characterization of Food Insecurity in a Canadian Paediatric Emergency Department

Abstract Background Food insecurity (FI), defined as inadequate or insecure access to food, is a key determinant of child health. FI is associated with a number of adverse physical, psychological and developmental health outcomes and increased emergency department (ED) use. The COVID-19 pandemic has exacerbated financial hardship faced by many families with an unprecedented rise in use of charitable food programs. Objectives We sought to determine the prevalence of FI among pediatric ED visits during the COVID-19 pandemic, compare this to pre-pandemic rates, and describe associated risk factors. Design/Methods From September to December 2021, families presenting to a tertiary Canadian paediatric ED were asked to complete a survey screening for FI with a validated two-item questionnaire, along with socio-demographic and child health information. Results were compared to data collected in 2012. Multivariable logistic regression was used to measure associations with FI. Results In 2021, 26% (n=173/665) of families identified as food insecure compared to 22.7% in 2012 (n=146/644), which was not statistically different (3.3%, 95% CI [-1.4%, 8.1%]). When the definition of FI is expanded to include use of charitable food assistance, the prevalence increased to 29.2%. In univariate analysis, FI was significantly associated with lack of primary care, caregivers born outside of Canada, status other than Canadian citizenship, having a child with a chronic medical condition, having financial strain related to medical expenses and reason for the ED visit being the child’s chronic condition. In multivariable analysis, only having more children in the home (OR 1.19, 95% CI [1.01, 1.41]), financial strain from medical expenses (OR 5.31, 95% CI [3.45, 8.18]) and lack of primary care access (OR 1.27, 95% CI [1.08, 1.51]) remained independent predictors of FI. Approximately half (48.5%) of food insecure families reported use of food charity, most commonly food banks (31.7%), while one-quarter (26%) received help from family or friends. Food insecure families indicated their preferred means of support in hospital would be free/low cost meals and financial assistance with medical expenses. Conclusion Greater than one in four families attending a Canadian tertiary pediatric ED screened positive for FI. FI was independently associated with lack of access to primary care, financial strain related to medical expenses, and greater number of children in the household. Further research is necessary to examine the effect of support interventions for families admitted to medical care facilities and financial support for chronic conditions.

Faecal incontinence in inflammatory bowel disease: The Nancy experience

BackgroundFaecal incontinence (FI) is a disabling condition in patients with inflammatory bowel disease (IBD). The diagnosis of FI is not easy as patients are reluctant to report this embarrassing symptom. The objectives of this study were to characterize the prevalence of FI in IBD patients using available scoring systems, and to identify associated risk factors. MethodsA FI clinic was implemented in routine practice between January 2020 and April 2021. FI was defined as a Wexner score ≥5. Factors associated with FI were analyzed. ResultsA total of 319 consecutive patients with IBD were included. The prevalence of FI was 16.4% (53/319). Age >45 years at inclusion (Odd ratio (OR)=3.33, Confidence interval (CI) 95% 1.40–7.94), diarrhea (three stools at least per day) (OR=2.94, CI 95% 1.16–7.45), stool consistency according to the Bristol stool chart (OR=2.23, CI 95% 1.00–4.99), and abdominal pain (OR=2.24, CI 95% 1.10–4.53) were independently associated with FI in a multivariate model analysis. ConclusionsApproximately one fifth of IBD patients reported FI in this real-world cohort, using an available scoring system. Increased age, diarrhea, stool consistency according to the Bristol stool chart, and abdominal pain were associated with FI. A systematic screening of FI would allow a better management of this disabling condition.

The Prevalence and Covariates of Food Insecurity Across Gestation and Postpartum Among Women of Mixed HIV Status in Nyanza Region, Kenya

Abstract Objectives Food insecurity (FI) is recognized as an important predictor of a range of health outcomes, including HIV acquisition and progression. Less is understood about the drivers of FI during the first 1000 days. Therefore we assessed the prevalence and covariates of FI among women of mixed HIV status in southwestern Kenya from pregnancy to 21 months postpartum. Methods The prevalence of FI was measured amongst all pregnant women attending 7 antenatal clinics in the Nyanza region, Kenya (n = 954) between 2015 and 2017 using the Individually Focused Food Insecurity Access Scale (IFIAS, range: 0–27). Subsequently, equal proportions of HIV-infected and -uninfected pregnant women (n = 363) were enrolled into an observational study and surveyed at 9 timepoints. Results In the population-based sample, 81% were severely food insecure. In the study cohort, the mean (SD) IFIAS score was 15.4 (6.1); 88% were considered severely food insecure. In longitudinal logistic regression models of FI (severe vs. not severe) from pregnancy to 21 m postpartum, greater depression scores, lower social support, greater stress, rural residence, and having dependents under 15-years were associated with greater IFIAS scores. Surprisingly, HIV infection, gestation age, education, and maternal age did not predict IFIAS scores. Conclusions These findings suggest programs in severely food insecure communities should also address psychosocial well-being of women to improve health outcomes. Funding Sources National Institute of Mental Health (K01 MH098902 and R21MH108444).

Pelvic floor disorders in women with premature ovarian insufficiency: a cross-sectional study.

This study aimed to investigate the prevalence of self-reported main pelvic floor disorders (PFD) (urinary incontinence [UI], pelvic organ prolapse [POP], and fecal incontinence [FI]) and its associated factors in women with premature ovarian insufficiency (POI) and a control group. This was a cross-sectional study wherein two groups were interviewed from August, 2017 to November, 2018-women with POI (n = 150) and a control group matched for age and body weight (n = 150). Sociodemographic variables and two questionnaires validated in Brazilian Portuguese language for PFD (Kings Health Questionnaire [KHQ] and Pelvic Floor Distress Inventory-20 [PFDI-20]) were used. Laycock's power, endurance, repetitions, fast contractions, every contraction timed (PERFECT) scale for pelvic floor muscle assessment was used in both groups. The prevalence of self-reported UI was 27.33% and 37.33% for POI and control groups (P > 0.05), respectively. There was no perceived difference regarding the prevalence of POP (9.33% POI group vs 8% control group; P = 0.682) and FI (8% POI vs 4% control group; P = 0.145). The P (power) (P = 0.46), E (endurance) (P = 0.91), R (repetitions) (P = 0.88), and F (fast contractions) (P = 0.19) values were statistically similar in both the groups. Multivariate analysis (n = 141) showed that higher weight (odds ratio [OR] 1.047 [1.018-1.076]; P < 0.001) and gravidity rates (OR 1.627 [1.169-2.266]; P < 0.01) were risk factors for UI and higher weight (OR 1.046 [1.010-1.084]; P = 0.01), and presence of comorbidities (OR 8.75 [1.07-71.44]; P < 0.01) were risk factors for POP in the POI group; there was no variable that was associated with FI. Women with POI did not have significant differences when compared with the control group regarding the prevalence of PFD and pelvic floor muscle assessment. Having higher weight and gravidity rates were associated with self-reported UI, while the presence of comorbidities and higher weight were risk factors for POP in the POI group. : Video Summary:http://links.lww.com/MENO/A555.

Experiences of Food Insecurity Modeled by Redundancy Analysis: A Cross-sectional Study of Uganda, 2014–2017 (P04-034-19)

ObjectivesFood insecurity (FI) is one of the leading health and nutrition issues in Uganda, where it affects 30% of the population of the country. It negatively impacts physical, mental, and social health that in turn affect nutritional requirements. The purpose of this study was therefore to (1) determine the prevalence of FI in Uganda from 2014 to 2017 (2) assess whether or not the linear additive combination of socio-economic and demographic factors affect FI in Uganda in the studied years; and (3) assess the association between FI and Physical Health Index (PHI). MethodsWe used Gallup World Poll data for Uganda from 2014 to 2017, 4000 respondents (>15 yr). FI was assessed in eight binary response items measured according to the Food Insecurity Experience Scale (FIES) (Voices of Hungry project, Food and Agriculture Organization of the United Nations). For redundancy analyses (RDA), the rda function (vegan package in R) was used. Path analysis was used to investigate assumptions regarding recursivity and directions of causal relationships. ResultsThe linear combination of socioeconomic and demographic factors explained on average 18% of the variance in the items of the FIES. Nevertheless, permutation tests indicated the high level of statistical significance of the RDA models (all P = .0001, the lowest possible value after 999 permutations). Linear regression indicated that the raw FIES score increased by approximately .5 per year. High levels of the PHI were associated with low levels of FI. Furthermore, low levels of PHI were correlated with increased business corruption in 2016 and 2017. Heterogeneous associations between business corruption and levels of FI was found over the four years of the study. Unemployment, low education levels, low income, being single, and living in a larger household and in a large city were positively associated with FI. As expected, household size was negatively correlated with income in 2014, 2016, and 2017. ConclusionsThe results indicated that the studied factors of FI explained a statistically significant portion of the variance in experiences of FI in Uganda in the years of the study. Further structural equation modeling (path modeling) will be necessary for the evaluation and proposals of policies and programs related to food security, health, and nutrition in Uganda. Funding SourcesNone. Supporting Tables, Images and/or Graphs▪▪▪▪

Child food insecurity in the UK: a rapid review

BackgroundFood insecurity (FI) is a multifaceted, socioeconomic problem involving difficulties accessing sufficient, safe and nutritious food to meet people’s dietary requirements and preferences for a healthy life. For children experiencing FI, there are some potentially negative developmental consequences and it is, therefore, important to understand the links between FI and children’s health and well-being as well as any strategies undertaken to address FI. The overall objective of this assessment was to determine the nature, extent and consequences of FI affecting children (aged ≤ 18 years) in the UK.ObjectiveTo determine the nature, extent and consequences of FI affecting children (aged ≤ 18 years) in the UK.Data sourcesThe databases searched on 4 December 2017 included MEDLINE (including In-Process &amp; Other Non-Indexed Citations and E-pub ahead of print files), EMBASE, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Commonwealth Agricultural Bureaux (CAB) abstracts, The Cochrane Library, Education Resources Information Centre (ERIC), PsycINFO, the Social Science Citation Index and the Applied Social Sciences Index and Abstracts (ASSIA).MethodsA rapid review of the current published and unpublished literature was conducted, including all study designs from specified high-income countries in children aged ≤ 18 years. Searches were conducted of major health-care, nutrition, education and social science databases from 1995 onwards, and websites of relevant UK and international organisations. Final searches were undertaken in December 2017.ResultsIn total, 109 studies were selected. Only five studies were conducted in the UK, four of which provided qualitative data. Possible factors associated with child FI were identified, for example socioeconomic status, material deprivation, living in public housing and having unemployed or poorly educated parents. Children’s health, well-being and academic outcomes were all negatively affected by FI. The mediating effects of family stressors and parenting practices in the relationship between FI and children’s health and well-being outcomes were not clear. Food assistance programmes were generally effective in mitigating FI and improving nutritional outcomes (including hunger) in the short term, but did not eradicate FI, eliminate its effects on children’s health or have an impact on academic outcomes. No reports assessing the prevalence of child FI in the UK or the cost-effectiveness and sustainability of interventions to tackle FI were identified.LimitationsThere was a lack of consistency in how FI was defined and measured across studies. Most of the studies used indirect measurements of child FI through parental reports. The majority of studies were conducted in North America. Only five studies were conducted in the UK. Thirty potentially relevant studies were not included in the review as a result of time and resource constraints. Most studies were observational and caution is advised in interpreting their results.ConclusionsA number of factors that were related to child FI were identified, as were negative associations between child FI and physical, mental and social outcomes. However, these findings should be interpreted with caution because of the correlational nature of the analyses and the fact that it is difficult to determine if some factors are predictors or consequences of FI.Future researchThere is an urgent requirement for the development of a reliable instrument to measure and monitor child FI in the UK and for well-designed interventions or programmes to tackle child FI.Study registrationThis study is registered as PROSPERO CRD42017084818.FundingThe National Institute for Health Research Public Health Research programme. The Health Services Research Unit is core-funded by the Chief Scientist Office of the Scottish Government Health and Social Care Directorates.

Prevalence and determinants of food insecurity in migrant Sub-Saharan African and Caribbean households in Ottawa, Canada

PurposeFood insecurity (FI) is an important social determinant of health and is linked with higher health care costs. There is a high prevalence of FI among recent migrant households in Canada. The purpose of this paper is to evaluate the prevalence of FI in Sub-Saharan African and Caribbean migrants in Ottawa, and to explore determinants of FI in that population.Design/methodology/approachA cross-sectional study was conducted among 190 mothers born in Sub-Saharan Africa or the Caribbean living in Ottawa and having a child between 6 and 12 years old. Health Canada’s Household Food Security Survey Module was used to evaluate participants’ food security in the past 12 months. χ2 tests and multivariate logistic regression analyses were used to measure determinants of FI (n=182).FindingsA very high rate of FI (45.1 percent) was found among participants. When numerous determinants of FI were included in a multivariate model, household FI was associated with Caribbean origin, low education attainment, lone motherhood, living in Canada for five years or less and reliance on social assistance.Originality/valueThese findings highlight the need for FI to be explicitly addressed in migrant integration strategies in order to improve their financial power to purchase sufficient, nutritious and culturally acceptable foods. Enhancing migrants’ access to affordable child care and well-paid jobs, improving social assistance programs and providing more affordable subsidized housing programs could be beneficial.

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Frequency of Food Insecurity and Associated Health Outcomes in Pediatric Patients at a Federally Qualified Health Center.

The present study was designed to identify the prevalence of FI and the association of household FI with the health status of pediatric patients seen at a Federally Qualified Health Center in New Jerseywhich provides health care mainly for Latinopatients. Patients were included if they were screened for FI at their well visits during a 4-month period following implementation of the 2-item screening tool recommended by American Academy of Pediatrics. We compared demographic and morbidity data of children with FI to those living in food-secure households. The results are presented as the distribution of frequency (%) and odds ratios (OR) with 95% confidence interval (95% CI). FI was detected in 15.8% (95% CI 14.2-17.5%) of 486 studied children. We recorded higher rates of anemia (10.4 vs. 3.2%, p < 0.005), hypercholesterolemia (10.4 vs. 3.4%, p < 0.01), and any morbidity (24.7 vs. 9.3%, p < 0.02) in children living in FI households. Multivariate logistic regression analysis revealed an association of household FI with at least one recorded morbidity independent of the patient's age, gender, and body mass index (OR 1.79, 95% CI 1.31-2.43). No one was diagnosed with diabetes, and only a few with asthma and hypertension. We have concluded that living in households with FI increased the risk for unfavorable health outcomes in a predominantly economically disadvantage community of children within the U.S.

Prevalence and Characteristics of Pelvic Floor Dysfunction in a Tertiary Care Center in Indonesia

Objective: To determine the prevalence and characteristics of pelvic floor dysfunction (PFD) in Jakarta, Indonesia.&#x0D; Methods: A cross sectional study was conducted at gynecology, endocrinology, and urogynecology clinic of Dr. Cipto Mangunkusumo Hospital during the period from January 2016 to April 2016. Subjects were selected using consecutive sampling. Data were taken using research and POP-Q form.&#x0D; Results: A total of 197 subjects were recruited. The prevalence of patients with PFD was 33%. The prevalence of POP, UI, and FI were 26.4%, 15.3% and 2.5%; respectively. Association between individual characteristics and PFD was found on women aged ≥ 60 and aged 40-59 years old with 69 and 14 times probability to be PFD. The probability of developing PFD was 76 and 14.2 times in multiparity and primiparity. Woman with vaginal delivery had a change to develop PFD 1.9 times and postmenopausal woman had a probability 18 times. The infuencing risk factor in PFD were age parity, race, mode of delivery, and menopausal status.&#x0D; Conclusion: Pelvic floor dysfunction affects a substantial of women and increases with age, parity and aging.&#x0D; [Indones J Obstet Gynecol 2017; 5-3: 168-172]&#x0D; Keywords: fecal incontinence, pelvic floor dysfunction, pelvic organ prolapse, urinary incontinence

Systematic review of the prevalence of faecal incontinence.

Faecal incontinence (FI) is widely recognized as a significant problem in the community. Conjecture exists around the proportion of the population affected. This systematic review evaluated studies reporting the community prevalence of FI in terms of methodology, design and definitions. MEDLINE, Embase, CINAHL, the Cochrane Collaboration and National Guideline databases were searched for studies investigating the prevalence of FI in community-based adults published from January 1966 to February 2015. Study data, including methodology, sample size, response rate, definition of FI and prevalence rates, were extracted on to a pro forma and appraised critically. Where possible, FI prevalence estimates were pooled. Thirty studies were analysed from 4840 screened articles. FI prevalence estimates varied from 1·4 to 19·5 per cent. This variation was explained by differences in data collection method and two factors within definitions of FI: type of stool and frequency of FI episodes. When these factors were accounted for, the FI prevalence at a threshold of at least once per month for liquid or solid stool was 8·3-8·4 per cent for face-to-face or telephone interviews, and 11·2-12·4 per cent for postal surveys. The pooled prevalence rate from studies for functional FI (defined by ROME II criteria) was 5·9 (95 per cent c.i. 5·6 to 6·3) per cent. When comparable methodologies and definitions are used, studies produce remarkably similar prevalence rates in different community populations. FI remains an unspoken symptom, with lower rates reported in personal interviews compared with anonymous postal questionnaires.

Food Insecurity and Chronic Diseases: The Editorial

ood Insecurity (FI) defines as the limited or uncertain availability of nutritionally foods adequately or the inability to achieve them in ways which is socially acceptable (1).FI is considered as an international public health issue particularly in developing countries (2). In 1995 the U.S. Department of Agriculture (USDA) reported the prevalence of FI in USA as 11.9% which increased to 14.6% in 2008 (3). Its prevalence was reported 5.7% in Finland, 10% in Canada (4), 50% in Malaysia (5) and 70% in Bolivia (6). The FI populations are at risk of low intake of fruits and vegetables, lower quality diets and so lower micronutrients intake and iron deficiency anemia (7). Limited available budget in FI subjects, leads to purchase cheaper and high dense calorie foods; which might contribute to obesity, and an increased susceptibility to chronic illnesses including type 2 diabetes, cancer, depression and other medical condition such as acne, dyspepsia and so on (8). The very first step to reduce the burden of FI is considering understanding ofits effects on health. By now, anumerous studies have aimed to examine the impacts of FI on health outcomes in different age/ gender groups such as children, adults and elder lies. Over the past few years, the paradox of FI and obesity/ overweight, diabetes, cancer and depression has been focused in literatures. Recently the FI have been considered in many other disorders. Literatures show a positive association between FI and acne (9), dyslipidemia (10) and dyspepsia (34% FI with hunger in patients versus 10% in counterparts) (9). There are a set of evidences in Iran (mostly published by the author of this editorial), which show food security is significantly associated with many problems and diseases including low birth weight, short stature in children (as FI increase, the height of children decrease), pre-eclampsia in pregnancy, the type of delivery, obesity/ overweight in women, lower intelligence quotient in children, osteoporosis (33.8% in food secure versus 66.2% in FI group), diabetes mellitus, rheumatoid arthritis and premenstrual syndrome (FI without hunger in teenagers with PMS was approximately 2 times more than those without PMS) [Published in Farsi Language]. However, other studies concerning association of FI with other diseases / problems are still needed. On the other hand, finding the prevalence of FI in different Iran provinces to draw a clear picture of FI looks necessary. Therefore, investigators are expected to work on prevalence and diseases associated to FI in their future studies. Financial disclosure The author declare no financial interest.