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Nam SJ, Suk J. Influence of health food literacy on willingness to pay for healthier foods: focus on food insecurity. Int J Equity Health 2024; 23:80. [PMID: 38649971 PMCID: PMC11036708 DOI: 10.1186/s12939-024-02135-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 02/23/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND The repercussions of food insecurity are widely recognized to negatively impact overall health and are influenced by a complex interplay of physiological, psychological, social, and environmental factors. METHODS This study examined the disparities in food consumption and literacy between among food security households and food insecurity households using data from the Korea Rural Economic Institute's 2022 Consumer Behavior Survey for Food, which involved 3,321 respondents. RESULTS Food security households had a greater understanding of and better attitude toward healthier food choices than food insecurity households. Economic ability was identified as having the most significant association with food purchasing behavior, with food security households spending more on average than food insecurity households. Structural equation modeling demonstrated the association of knowledge and attitude with dietary implementation and underscored the significance of consumer literacy as a factor related to willingness to pay for healthier foods. CONCLUSIONS This study underscores the intertwined relationships among financial capacity, knowledge, and health-conscious dietary choices. It also suggests the need for targeted interventions addressing economic and educational gaps to foster healthier food consumption patterns across different socioeconomic contexts.
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Affiliation(s)
- Su-Jung Nam
- Department of Consumer Sciences, Convergence Program for Social Innovation, College of Social Sciences, Sungkyunkwan University, Seoul, Republic of Korea
| | - Jaehye Suk
- Convergence Program for Social Innovation, College of Social Sciences, Sungkyunkwan University, Seoul, Republic of Korea.
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2
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Lamont A, Speed D. Food insecurity and body dissatisfaction in a sample of Canadian adults. J Health Psychol 2024:13591053241242342. [PMID: 38566401 DOI: 10.1177/13591053241242342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Abstract
Food insecurity may predict poorer body image, which is associated with increased risk of mental health problems. However, minimal attention has been given to the food insecurity-body image link and to factors that may influence this link, such as assigned sex; importantly, females are more likely to experience both food insecurity and body dissatisfaction. The present study used data from the 2017 to 2018 Canadian Community Health Survey (N = 32,017) to investigate the effects of food insecurity and sex on body satisfaction via generalized ordered logistic regression. Results indicated: (1) Food insecurity predicted lower odds of body satisfaction, (2) Males were more likely than females to be satisfied with their bodies, and (3) Food insecurity no longer predicted body satisfaction following the inclusion of sex. Findings suggest the association between food insecurity and body satisfaction may largely be driven by the link between food insecurity and sex. Further investigation is warranted.
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Affiliation(s)
| | - David Speed
- University of New Brunswick - Saint John, Canada
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Bernhart JA, Fellers AW, Wilson MJ, Hutto B, Bailey S, Turner-McGrievy GM. COVID-19 Pandemic Associations on Mental and Physical Health in African Americans Participating in a Behavioral Intervention. J Racial Ethn Health Disparities 2023; 10:3070-3076. [PMID: 36469289 PMCID: PMC9734885 DOI: 10.1007/s40615-022-01481-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 11/01/2022] [Accepted: 11/23/2022] [Indexed: 12/12/2022]
Abstract
The COVID-19 pandemic has had disproportionate effects on communities of color, with higher death rates among African Americans (AA). The purpose of this study was to assess associations in African Americans' mental and physical health with the COVID-19 pandemic. Data for this study came from a larger nutrition intervention of AAs in the Southeastern United States, the Nutritious Eating with Soul study. Data collected before and after March 15, 2020 (the day when local South Carolina schools and businesses closed), were analyzed to assess the association of the pandemic on participants' stress, control of healthy eating, physical activity, and body mass index. Repeated measures analysis of covariance using full maximum likelihood estimation to handle missing data was used. At the onset of the COVID-19 pandemic, 150 participants were enrolled in the study (48.2 ± 10.6 years old, 79% female, 75% with college degree or higher). Participants' reporting of stress did not show statistically significant change over time. Cognitive control increased 1.43 points (F = 20.60, p < 0.0001) and body mass index increased 0.72 kg/m2 (F = 10.68, p = 0.001). Future longitudinal studies should investigate how the COVID-19 pandemic continues to present challenges to understanding and improving health among African Americans. The study is registered at www.clinicaltrials.gov NCT03354377.
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Affiliation(s)
- J A Bernhart
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Room 536, 915 Greene Street, SC, 29208, Columbia, USA.
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Columbia, SC, 29208, USA.
| | - A W Fellers
- University of South Carolina School of Medicine, 6439 Garners Ferry Road, Columbia, SC, 29209, USA
| | - M J Wilson
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Columbia, SC, 29208, USA
- Department of Health Services, Policy, and Management, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC, 29208, USA
| | - B Hutto
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Columbia, SC, 29208, USA
| | - S Bailey
- Department of Health Services, Policy, and Management, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC, 29208, USA
| | - G M Turner-McGrievy
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Room 536, 915 Greene Street, SC, 29208, Columbia, USA
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Kibibi NI, Dena I, Cummings PDW, Hicks CD, Bao W, Schweizer ML. Obesity in Refugees post-resettlement in a high-income country: a meta-analysis. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01688-1. [PMID: 37468741 DOI: 10.1007/s40615-023-01688-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 06/10/2023] [Accepted: 06/18/2023] [Indexed: 07/21/2023]
Abstract
BACKGROUND Refugees have a high prevalence of obesity post resettlement, but few studies have compared their risk of obesity to those of the host population. We systematically investigated the association between refugee status and obesity after resettlement in a high-income nation. METHODS We searched PubMed, Embase, OpenGrey and bibliographies of retrieved articles, with no date, location, and language restrictions, for observational studies assessing obesity rates in resettled refugees compared to the host population. RESULTS Nine studies were analyzed. We found no evidence of increased risk of obesity among refugees compared to the host population, with significant heterogeneity across studies. However, the risk of obesity among refugee men were significantly lower than the host population. DISCUSSION The heterogeneity between studies calls for more high-quality research to examine the risk of obesity among refugees compared to the host population in high-income countries. This will enable results to be pooled to provide more decisive evidence about obesity trends among refugees post migration in a high-income nation.
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Affiliation(s)
- Niclette I Kibibi
- Department of Epidemiology, University of Iowa College of Public Health, 145 N. Riverside Dr., S400 CPHB, Iowa City, IA, 52242, USA.
| | - Isabelle Dena
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, SK, Canada
| | - Precious de-Winton Cummings
- Department of Epidemiology, University of Iowa College of Public Health, 145 N. Riverside Dr., S400 CPHB, Iowa City, IA, 52242, USA
| | - Chelsea D Hicks
- Harborview Injury Prevention and Research Center, Department of Pediatrics, University of Washington, Seattle, WA, USA
| | - Wei Bao
- Institute of Public Health Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230026, Anhui, China
| | - Marin L Schweizer
- Division of Infectious Disease, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
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5
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Eicher-Miller HA, Graves L, McGowan B, Mayfield BJ, Connolly BA, Stevens W, Abbott A. A Scoping Review of Household Factors Contributing to Dietary Quality and Food Security in Low-Income Households with School-Age Children in the United States. Adv Nutr 2023; 14:914-945. [PMID: 37182740 PMCID: PMC10334140 DOI: 10.1016/j.advnut.2023.05.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 04/05/2023] [Accepted: 05/09/2023] [Indexed: 05/16/2023] Open
Abstract
Low-income and food-insecure households are at risk of poor dietary quality and even more severe food insecurity. Especially in childhood, consuming a nutritionally adequate diet is an essential driver of health, growth, and development. Household-level factors can present challenges to support the nutritional needs of low-income and food-insecure household members. The aim of this scoping review is to identify the contributing household factors to dietary quality and food security in US households of school-aged children 5 to 19 years and synthesize the evidence around emergent themes for application to future interventions. The scoping review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols Extension for Scoping Reviews using search terms addressing food insecurity, low income, and dietary behaviors in the database PubMed. Screening by 3 independent reviewers of the title, abstract, and full study phases identified 44 studies. The 5 themes around which the studies grouped were: parental behaviors, child/adolescent behaviors, food procurement behaviors, food preparation behaviors, and household environment factors. Most studies were cross-sectional (n = 41, 93%) and focused on parental behaviors (n = 31, 70%), followed by food preparation and procurement behaviors. The themes identified were interrelated and suggest that incorporating education on parent and child behaviors that influence food procurement and preparation, along with strengthening organization and planning in the household environment, may hold promise to improve dietary quality and food security among food-insecure and low-income households. The findings can be used to inform future nutrition education interventions aimed at improving dietary quality and food security in households with school-aged children.
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Affiliation(s)
| | - Lisa Graves
- Department of Nutrition Science, Purdue University, West Lafayette, IN, USA
| | - Bethany McGowan
- Libraries and School of Information Studies, Purdue University, West Lafayette, IN, USA
| | | | - Blake A Connolly
- College of Health and Human Sciences, Purdue Extension, Purdue University, West Lafayette, IN, USA
| | - Wanda Stevens
- College of Health and Human Sciences, Purdue Extension, Purdue University, West Lafayette, IN, USA
| | - Angela Abbott
- College of Health and Human Sciences, Purdue Extension, Purdue University, West Lafayette, IN, USA
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Patel P, Selvaraju V, Babu JR, Geetha T. Association of the DNA Methylation of Obesity-Related Genes with the Dietary Nutrient Intake in Children. Nutrients 2023; 15:2840. [PMID: 37447167 DOI: 10.3390/nu15132840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 06/16/2023] [Accepted: 06/20/2023] [Indexed: 07/15/2023] Open
Abstract
The occurrence of obesity stems from both genetic and external influences. Despite thorough research and attempts to address it through various means such as dietary changes, physical activity, education, and medications, a lasting solution to this widespread problem remains elusive. Nutrients play a crucial role in various cellular processes, including the regulation of gene expression. One of the mechanisms by which nutrients can affect gene expression is through DNA methylation. This modification can alter the accessibility of DNA to transcription factors and other regulatory proteins, thereby influencing gene expression. Nutrients such as folate and vitamin B12 are involved in the one-carbon metabolism pathway, which provides the methyl groups necessary for DNA methylation. Studies have shown that the inadequate intake of these nutrients can lead to alterations in DNA methylation patterns. For this study, we aim to understand the differences in the association of the dietary intake between normal weight and overweight/obese children and between European American and African American children with the DNA methylation of the three genes NRF1, FTO, and LEPR. The research discovered a significant association between the nutritional intake of 6-10-years-old children, particularly the methyl donors present in their diet, and the methylation of the NRF1, FTO, and LEPR genes. Additionally, the study emphasizes the significance of considering health inequalities, particularly family income and maternal education, when investigating the epigenetic impact of methyl donors in diet and gene methylation.
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Affiliation(s)
- Priyadarshni Patel
- Department of Nutritional Sciences, Auburn University, Auburn, AL 36849, USA
| | | | - Jeganathan Ramesh Babu
- Department of Nutritional Sciences, Auburn University, Auburn, AL 36849, USA
- Boshell Metabolic Diseases and Diabetes Program, Auburn University, Auburn, AL 36849, USA
| | - Thangiah Geetha
- Department of Nutritional Sciences, Auburn University, Auburn, AL 36849, USA
- Boshell Metabolic Diseases and Diabetes Program, Auburn University, Auburn, AL 36849, USA
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Price M, Jeffery T. An Analysis of Socioeconomic Determinants of the Black-White Disparity in Food Insecurity Rates in the US. Foods 2023; 12:foods12112228. [PMID: 37297472 DOI: 10.3390/foods12112228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/21/2023] [Accepted: 05/25/2023] [Indexed: 06/12/2023] Open
Abstract
Previous research has not fully explored socioeconomic factors that influence the Black-White food insecurity disparities at the state and county levels in the United States. The goal of this study was to identify socioeconomic determinants associated with the Black-White food insecurity gap in the US at the state and county levels with rigorous quantitative investigation. The 2019 Map the Meal Gap dataset and multivariate regression analyses were used to identify factors associated with the prevalence of the Black-White disparity in food insecurity rates. Unemployment rate and median income gaps were found to be the strongest predictors of the Black-White disparity in food insecurity and the Black food insecurity rates in both state- and county-level models. Specifically, a 1% increase in Black unemployment rate compared with White unemployment rate was associated with a 0.918% and 0.232% increase in the Black-White disparity in food insecurity on average at the state and county levels, respectively. This study highlights the potential root causes of food insecurity and significant socioeconomic determinants associated with the Black-White food insecurity gap at the state and county levels in the US. Policymakers and program creators should implement action plans to address the income disparities and reduce unemployment rates among Blacks to eradicate this gap and ensure equity in food access between Blacks and Whites.
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Affiliation(s)
- Mya Price
- College of Agriculture, Urban Sustainability, and Environmental Sciences, University of the District of Columbia, 4200, Connecticut Ave., Washington, DC 20008, USA
| | - Tia Jeffery
- College of Agriculture, Urban Sustainability, and Environmental Sciences, University of the District of Columbia, 4200, Connecticut Ave., Washington, DC 20008, USA
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Nordström M, Carlsson P, Ericson D, Hedenbjörk-Lager A, Hänsel Petersson G. Common resilience factors among healthy individuals exposed to chronic adversity: a systematic review. Acta Odontol Scand 2023; 81:176-185. [PMID: 35811490 DOI: 10.1080/00016357.2022.2095021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVE To identify common resilience factors against non-communicable diseases (dental caries, diabetes type II, obesity and cardiovascular disease) among healthy individuals exposed to chronic adversity. MATERIALS AND METHODS The databases MEDLINE (via PubMed), Scopus and CINAHL were searched. Observational studies in English assessing resilience factors among populations living in chronic adversity were included. Intervention studies, systematic reviews, non-original articles and qualitative studies were excluded. There were no restrictions regarding publication year or age. No meta-analysis could be done. Quality assessments were made with the Newcastle-Ottawa scale (NOS). RESULTS A final total of 41 studies were included in this systematic review. The investigated health resilience factors were divided into the following domains: environmental (community and family) and individual (behavioural and psychosocial). A narrative synthesis of the results was made according to the domains. CONCLUSIONS Individual psychosocial, family and environmental factors play a role as health resilience factors in populations living in chronic adversity. However, the inconclusive results suggest that these factors do not act in isolation but interplay in a complex manner and that their interaction may vary during the life course, in different contexts, and over time.
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Affiliation(s)
- Marie Nordström
- Department of Cariology, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Peter Carlsson
- Department of Cariology, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Dan Ericson
- Department of Cariology, Faculty of Odontology, Malmö University, Malmö, Sweden
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Kells MR, Davis HA, Todorov S, Wildes JE. Health literacy and eating disorder pathology in women with food insecurity: A preliminary cross-sectional study. Eat Behav 2023; 49:101727. [PMID: 37099830 DOI: 10.1016/j.eatbeh.2023.101727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 02/28/2023] [Accepted: 04/05/2023] [Indexed: 04/28/2023]
Abstract
Food insecurity (FI), or limited consistent access to food, is associated with eating disorder (ED) pathology; however, the underlying mechanisms of this relationship remain unclear. Health literacy, or the ability to comprehend and apply health-related information to decision making, is linked to FI and has implications for outcomes across a broad range of diagnoses. The purpose of this study was to examine associations between health literacy and ED symptoms in a sample of 99 women with FI. Linear regression tested cross-sectional associations between scores on The Newest Vital Sign (NVS), a measure of health literacy, and scores on the Eating Pathology Symptom Inventory (EPSI) and behaviors reported in the Eating Disorder Diagnostic Interview (EDDI). Logistic regression examined the likelihood of ED diagnosis in relation to NVS score. The sample mean (SD) age was 40.3 (14.3) years, and participants self-identified as 54.5 % White, 30.3 % Black, and 13.8 % other. Respondents self-reported 13.1 % marginal, 28.3 % low, and 58.6 % very low food security. Mean NVS score was 4.45, and significantly higher for White compared to Black individuals (F = 3.96, p = .02, η2 = 0.76), but not between other groups. No difference in NVS score by FI status was observed. EPSI Body Dissatisfaction was positively associated with NVS score. No associations were found between remaining EPSI subscales, eating behaviors, or ED diagnosis. White women, but not other groups, were found to have significant negative relationship between NVS and EPSI restricting. Future longitudinal research including components of health literacy related to eating in individuals with FI is warranted.
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Affiliation(s)
- Meredith R Kells
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA; School of Nursing, University of Rochester, Rochester, NY, USA.
| | - Heather A Davis
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA; Virginia Polytechnic Institute and State University, Department of Psychology, Blacksburg, VA, USA
| | - Sophia Todorov
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | - Jennifer E Wildes
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
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Herbozo S, Brown KL, Burke NL, LaRose JG. A Call to Reconceptualize Obesity Treatment in Service of Health Equity: Review of Evidence and Future Directions. Curr Obes Rep 2023; 12:24-35. [PMID: 36729299 PMCID: PMC9894524 DOI: 10.1007/s13679-023-00493-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/10/2022] [Indexed: 02/03/2023]
Abstract
PURPOSE OF REVIEW Rates of obesity and associated comorbidities are higher among Black and Latino adults compared to white adults. We sought to provide an overview of both structural and individual factors contributing to obesity inequities and synthesize available evidence regarding treatment outcomes in Black and Latino adults, with an eye towards informing future directions. RECENT FINDINGS Obesity disparities are influenced by myriad systemic issues, yet the vast majority of interventions target individual-level factors only, and most behavioral treatments fail to target drivers beyond eating and physical activity. Extant treatments are not equally accessible, affordable, or effective among Black and Latino adults compared with white counterparts. Asset-based, culturally relevant interventions that target the root causes of obesity and address intersectional stress-designed in partnership with intended beneficiaries-are urgently needed. Treatment trials must improve enrollment of Black and Latino adults and report treatment outcomes by race and ethnicity.
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Affiliation(s)
- Sylvia Herbozo
- Department of Surgery, Department of Psychiatry and Behavioral Sciences, College of Medicine, University of Illinois at Chicago, Chicago, USA.
- Department of Psychiatry and Behavioral Sciences and Department of Surgery, Rush University Medical Center, 1725 West Harrison Street, Chicago, IL, 60612, USA.
| | - Kristal Lyn Brown
- Division of General Internal Medicine, School of Medicine, The Johns Hopkins University, Baltimore, USA
| | - Natasha L Burke
- Department of Psychology, Fordham University, The Bronx, USA
| | - Jessica Gokee LaRose
- Department of Health Behavior and Policy, School of Medicine, Virginia Commonwealth University, Richmond, USA
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Hwang SY, Park JE. A Study on the Relationship between Food Security and the Number of Remaining Teeth in Korean Adults: The Korea National Health and Nutrition Examination Survey (KNHANES VII), 2016-2018. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2964. [PMID: 36833660 PMCID: PMC9957181 DOI: 10.3390/ijerph20042964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 02/03/2023] [Accepted: 02/07/2023] [Indexed: 06/18/2023]
Abstract
Food security is important for human health and quality of life. This study investigated the association between food security and the number of remaining teeth in Korean adults. Raw data from the Korea National Health and Nutrition Examination Survey (KNHANES) VII (2016-2018) were analyzed, including data from 13,199 adults aged 19 years or older. The associations between food security and number of teeth were assessed using multiple multinomial logistic regression models after adjusting for demographic and health factors as covariates. In the model adjusted for all socioeconomic, medical, and behavior variables, the odds ratio of tooth loss (16-20 teeth) was 3.80 (95% confidence interval [CI] 1.56-9.21) in the group of people that reported often feeling insecurity regarding various food groups compared to those who reported feeling food security. The results of this study demonstrated an association between food security and the number of remaining teeth in Korean adults. Therefore, food security is essential for improving lifelong oral health.
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Affiliation(s)
- Su-Yeon Hwang
- Department of Dental Hygiene, Daejeon Institute of Science and Technology, Daejeon 35408, Republic of Korea
| | - Jung-Eun Park
- Department of Dental Hygiene, College of Health Science, Dankook University, Cheonan-si 31116, Republic of Korea
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Eskandari F, Lake AA, Rose K, Butler M, O'Malley C. A mixed-method systematic review and meta-analysis of the influences of food environments and food insecurity on obesity in high-income countries. Food Sci Nutr 2022; 10:3689-3723. [PMID: 36348796 PMCID: PMC9632201 DOI: 10.1002/fsn3.2969] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 05/26/2022] [Accepted: 06/17/2022] [Indexed: 11/10/2022] Open
Abstract
Obesity remains a serious public health concern in rich countries and the current obesogenic food environments and food insecurity are predictors of this disease. The impact of these variables on rising obesity trends is, however, mixed and inconsistent, due to measurement issues and cross-sectional study designs. To further the work in this area, this review aimed to summarize quantitative and qualitative data on the relationship between these variables, among adults and children across high-income countries. A mixed-method systematic review was conducted using 13 electronic databases, up to August 2021. Two authors independently extracted data and evaluated quality of publications. Random-effects meta-analysis was used to estimate the odds ratio (OR) for the association between food insecurity and obesity. Where statistical pooling for extracted statistics related to food environments was not possible due to heterogeneity, a narrative synthesis was performed. Meta-analysis of 36,113 adults and children showed statistically significant associations between food insecurity and obesity (OR: 1.503, 95% confidence interval: 1.432-1.577, p < .05). Narrative synthesis showed association between different types of food environments and obesity. Findings from qualitative studies regarding a reliance on energy-dense, nutrient-poor foods owing to their affordability and accessibility aligned with findings from quantitative studies. Results from both qualitative and quantitative studies regarding the potential links between increased body weight and participation in food assistance programs such as food banks were supportive of weight gain. To address obesity among individuals experiencing food insecurity, wide-reaching approaches are required, especially among those surrounded by unhealthy food environments which could potentially influence food choice.
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Affiliation(s)
- Fatemeh Eskandari
- Centre for Public Health Research, School of Health and Life SciencesTeesside UniversityMiddlesbroughUK
- Fuse ‐ The Centre for Translational Research in Public HealthNewcastle upon TyneUK
| | - Amelia A. Lake
- Centre for Public Health Research, School of Health and Life SciencesTeesside UniversityMiddlesbroughUK
- Fuse ‐ The Centre for Translational Research in Public HealthNewcastle upon TyneUK
| | - Kelly Rose
- Centre for Public Health Research, School of Health and Life SciencesTeesside UniversityMiddlesbroughUK
- Fuse ‐ The Centre for Translational Research in Public HealthNewcastle upon TyneUK
| | - Mark Butler
- Centre for Public Health Research, School of Health and Life SciencesTeesside UniversityMiddlesbroughUK
| | - Claire O'Malley
- Centre for Public Health Research, School of Health and Life SciencesTeesside UniversityMiddlesbroughUK
- Fuse ‐ The Centre for Translational Research in Public HealthNewcastle upon TyneUK
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Dennard E, Kristjansson E, Tchangalova N, Totton S, Winham D, O’Connor A. Food insecurity among African Americans in the United States: A scoping review. PLoS One 2022; 17:e0274434. [PMID: 36094921 PMCID: PMC9467341 DOI: 10.1371/journal.pone.0274434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 08/09/2022] [Indexed: 11/18/2022] Open
Abstract
In 2019, the estimated prevalence of food insecurity for Black non-Hispanic households was higher than the national average due to health disparities exacerbated by forms of racial discrimination. During the COVID-19 pandemic, Black households have experienced higher rates of food insecurity when compared to other populations in the United States. The primary objectives of this review were to identify which risk factors have been investigated for an association with food insecurity, describe how food insecurity is measured across studies that have evaluated this outcome among African Americans, and determine which dimensions of food security (food accessibility, availability, and utilization) are captured by risk factors studied by authors. Food insecurity related studies were identified through a search of Google Scholar, PubMed, CINAHL Plus, MEDLINE®, PsycINFO, Health Source: Nursing/Academic Edition, and Web of Science™ (Clarivate), on May 20, 2021. Eligible studies were primary research studies, with a concurrent comparison group, published in English between 1995 and 2021. Ninety-eight relevant studies were included for data charting with 37 unique measurement tools, 115 risk factors, and 93 possible consequences of food insecurity identified. Few studies examined factors linked to racial discrimination, behaviour, or risk factors that mapped to the food availability dimension of food security. Infrequently studied factors, such as lifetime racial discrimination, socioeconomic status (SES), and income insecurity need further investigation while frequently studied factors such as age, education, race/ethnicity, and gender need to be summarized using a systematic review approach so that risk factor impact can be better assessed. Risk factors linked to racial discrimination and food insecurity need to be better understood in order to minimize health disparities among African American adults during the COVID-19 pandemic and beyond.
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Affiliation(s)
- Elizabeth Dennard
- Office of Applied Research and Safety Assessment, Food and Drug Administration, Laurel, Maryland, United States of America
- * E-mail:
| | | | - Nedelina Tchangalova
- STEM Library, University of Maryland, College Park, Maryland, United States of America
| | - Sarah Totton
- Department of Population Medicine, University of Guelph, Guelph, Ontario, Canada
| | - Donna Winham
- Food Science and Human Nutrition, Iowa State University, Ames, Iowa, United States of America
| | - Annette O’Connor
- College of Veterinary Medicine, Michigan State University, East Lansing, Michigan, United States of America
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Novin ZS, Heshmati E, Qorbani M, Ghasemi Madani F, Zamankhani F, Sharifi L. The Prevalence of Food Insecurity and its Association with Non-Communicable Diseases Risk Factors: a Cross-Sectional Study in Alborz Province, Iran. Women Health 2022; 62:593-602. [DOI: 10.1080/03630242.2022.2097360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
| | | | - Mostfa Qorbani
- Research Deputy of Alborz University of Medical Sciences, Karaj, Iran
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15
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Gittelsohn J, Lewis EC, Martin NM, Zhu S, Poirier L, Van Dongen EJI, Ross A, Sundermeir SM, Labrique AB, Reznar MM, Igusa T, Trujillo AJ. The Baltimore Urban Food Distribution (BUD) App: Study Protocol to Assess the Feasibility of a Food Systems Intervention. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9138. [PMID: 35897500 PMCID: PMC9329906 DOI: 10.3390/ijerph19159138] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/17/2022] [Accepted: 07/22/2022] [Indexed: 02/05/2023]
Abstract
Low-income urban communities in the United States commonly lack ready access to healthy foods. This is due in part to a food distribution system that favors the provision of high-fat, high-sugar, high-sodium processed foods to small retail food stores, and impedes their healthier alternatives, such as fresh produce. The Baltimore Urban food Distribution (BUD) study is a multilevel, multicomponent systems intervention that aims to improve healthy food access in low-income neighborhoods of Baltimore, Maryland. The primary intervention is the BUD application (app), which uses the power of collective purchasing and delivery to affordably move foods from local producers and wholesalers to the city's many corner stores. We will implement the BUD app in a sample of 38 corner stores, randomized to intervention and comparison. Extensive evaluation will be conducted at each level of the intervention to assess overall feasibility and effectiveness via mixed methods, including app usage data, and process and impact measures on suppliers, corner stores, and consumers. BUD represents one of the first attempts to implement an intervention that engages multiple levels of a local food system. We anticipate that the app will provide a financially viable alternative for Baltimore corner stores to increase their stocking and sales of healthier foods, subsequently increasing healthy food access and improving diet-related health outcomes for under-resourced consumers. The design of the intervention and the evaluation plan of the BUD project are documented here, including future steps for scale-up. Trial registration #: NCT05010018.
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Affiliation(s)
- Joel Gittelsohn
- Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Emma C Lewis
- Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Nina M Martin
- Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Siyao Zhu
- Department of Civil and Systems Engineering, Johns Hopkins Whiting School of Engineering, Baltimore, MD 21205, USA
| | - Lisa Poirier
- Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | | | - Alexandra Ross
- Nutrition Epidemiology, School of Global Public Health, University of North Carolina Gillings, Chapel Hill, NC 27599, USA
| | - Samantha M Sundermeir
- Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Alain B Labrique
- Global Disease Epidemiology and Control, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Melissa M Reznar
- Interdisciplinary Health Sciences, Oakland University School of Health Sciences, Detroit, MI 48309, USA
| | - Takeru Igusa
- Department of Civil and Systems Engineering, Johns Hopkins Whiting School of Engineering, Baltimore, MD 21205, USA
| | - Antonio J Trujillo
- Health Systems, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
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16
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van der Velde LA, van Dijk WW, Numans ME, Kiefte-de Jong JC. Extending the Theory of Planned Behavior for Explaining Dietary Quality: The Role of Financial Scarcity and Food Insecurity Status. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2022; 54:636-646. [PMID: 35644785 DOI: 10.1016/j.jneb.2022.02.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 01/28/2022] [Accepted: 02/26/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To examine whether an extended Theory of Planned Behavior (TPB) that included finance-related barriers better explained dietary quality. DESIGN Cross-sectional survey. PARTICIPANTS One-thousand and thirty-three participants were included from a Dutch independent adult panel. MAIN OUTCOME Dietary quality. ANALYSIS Five TPB models were assessed: a traditional TPB, a TPB that included direct associations between attitude and subjective norm with dietary quality, a TPB that additionally included financial scarcity or food insecurity, and a TPB that additionally included financial scarcity and food insecurity simultaneously. Structural relationships among the constructs were tested to compare the explanatory power. RESULTS The traditional TPB showed poorest fit (χ2/degrees of freedom = 11; comparative fit index = 0.75; root mean square error of approximation [95% confidence interval], 0.10 [0.091-0.12]; standardized root mean square residual = 0.049), the most extended TPB (including both financial scarcity and food insecurity) showed best fit (χ2/degrees of freedom = 3.3; comparative fit index = 0.95; root mean square error of approximation [95% confidence interval], 0.050 [0.035-0.065]; standardized root mean square residual = 0.018). All 5 structure models explained ∼42% to 43% of the variance in intention; however, the variance in dietary quality was better explained by the extended TPB models, including food insecurity and/or financial scarcity (∼22%) compared with the traditional TBP (∼7%), indicating that these models better explained differences in dietary quality. CONCLUSIONS AND IMPLICATIONS These findings highlight the importance of accounting for finance-related barriers to healthy eating like financial scarcity or food insecurity to better understand individual dietary behaviors in lower socioeconomic groups.
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Affiliation(s)
- Laura A van der Velde
- Department of Public Health and Primary Care/Leiden University Medical Center-Campus the Hague, Leiden University Medical Centre, The Hague, the Netherlands.
| | - Wilco W van Dijk
- Department of Social, Economic and Organisational Psychology, and Knowledge Centre Psychology and Economic Behaviour, Leiden University, Leiden, the Netherlands
| | - Mattijs E Numans
- Department of Public Health and Primary Care/Leiden University Medical Center-Campus the Hague, Leiden University Medical Centre, The Hague, the Netherlands
| | - Jessica C Kiefte-de Jong
- Department of Public Health and Primary Care/Leiden University Medical Center-Campus the Hague, Leiden University Medical Centre, The Hague, the Netherlands
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17
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Becker N, Mkhonta A, Sibeko LN. The prevalence of overweight/obesity and its association with household food insecurity among women living with HIV in rural Eswatini. BMC Public Health 2022; 22:629. [PMID: 35361183 PMCID: PMC8969360 DOI: 10.1186/s12889-022-13036-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 03/11/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Eswatini is currently afflicted by an extremely high prevalence of HIV (27%) and malnutrition (both under-and over-nutrition). While rates of overweight/obesity in the general adult population have been documented, data on overweight/obesity and associated risk factors among women living with HIV (WLHIV) in Eswatini is limited. This study examines the prevalence of overweight/obesity and associated risk factors, with an emphasis on clarifying the association between household food insecurity and overweight/obesity for WLHIV in rural Eswatini. METHODS This cross-sectional study was conducted among WLHIV (n = 166) in rural communities of Eswatini. Data were collected using an interviewer-administered survey questionnaire between October and November, 2017. Body Mass Index (BMI) was calculated to determine overweight and obesity among study participants. Women with BMI values of 25 kg/m2 or greater were classified as being overweight/obese. Multivariable log-binomial regression models were used to examine associations between household food insecurity and overweight/obesity in our study. RESULTS Nearly a third (32.5%) of the women in our study were overweight and almost a quarter were obese (22.9%). We found significant associations between household food insecurity and overweight/obesity, with women who experienced household food insecurity the most being 0.38 times less likely to be overweight/obese compared to those who experienced household food insecurity the least (ARR: 0.38, 95% CI: 0.2-0.71). In our study sample, women who perceived themselves as being in poor health were less likely to be overweight/obese compared to those who perceived themselves as being in good health (ARR: 0.58, 95% CI: 0.39-0.86). We found significant associations between overweight/obesity and alcohol use, with the risk of overweight/obesity nearly 1.5 times higher among women who consumed alcohol compared to those who did not (ARR: 1.49, 95% CI: 1.07-2.05). CONCLUSIONS The high prevalence of overweight/obesity among food insecure women in poverty stricken communities may pose significant challenges for nutritional health and HIV management. With an increasing prevalence of overweight/obesity in food insecure households, there is a need to re-evaluate current strategies and develop multi-level targeted interventions that include prevention of excessive weight gain among women, particularly those living with HIV in rural Eswatini. HIV programs could include screening to identify individuals at risk for overweight/obesity in this population, and provide nutrition education for weight management for those individuals.
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Affiliation(s)
- Nozipho Becker
- Department of Nutrition, University of Massachusetts, Amherst, USA. .,Department of Food and Nutrition Sciences, University of Eswatini, Luyengo, Kingdom of Eswatini. .,Center for AIDS Prevention Studies, Division of Prevention Science, University of California, San Francisco, USA.
| | - Andile Mkhonta
- grid.12104.360000 0001 2289 8200Department of Food and Nutrition Sciences, University of Eswatini, Luyengo, Kingdom of Eswatini
| | - Lindiwe N. Sibeko
- grid.266683.f0000 0001 2166 5835Department of Nutrition, University of Massachusetts, Amherst, USA
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18
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The Evolution of Food Security: Where Are We Now, Where Should We Go Next? SUSTAINABILITY 2022. [DOI: 10.3390/su14063634] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Food security is one of the most challenging topics globally; however, the concept of food security has taken on additional dimensions that are general and are less detailed. This study aims to identify the intellectual structure of food security research and the changes in this structure. This paper analyzed 3169 documents from the Web of Science database through a bibliometric review. A review of the published documents shows an increasing trend over the past 46 years. In accordance with co-occurrence analysis, 125 keywords were grouped into five clusters: food security and sustainable development; food security and socioeconomic factors; food security policy and governance; coping strategies for poverty, inequality, and hunger; and modern food security management. This study identifies four streams within food security research: sustainability and environmental, socioeconomic, cultural, and political factors. The paper concludes that even though food security might investigate many significant areas, other new dimensions should still be considered. Further gaps in the literature emerge that present avenues for future research directions. Reviewing indicators and techniques of food security assessment and identifying high-risk groups should be a priority.
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19
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Long CR, Narcisse MR, Rowland B, Faitak B, Bailey MM, Gittelsohn J, Caspi CE, Niemeier J, English ES, McElfish PA. Food Pantry Usage Patterns are Associated with Client Sociodemographics and Health. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2022; 17:408-424. [PMID: 35935752 PMCID: PMC9355513 DOI: 10.1080/19320248.2021.2001404] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Characterizing food pantry (FP) clients' FP usage patterns may provide opportunities to tailor health-related interventions. Respondents (n=245) at seven FPs reported their frequency and reliance on FPs and their sociodemographics, health status, and health-related trade-offs. Clients were categorized via latent class analysis. Higher FP usage was associated with being older, having a household member with heart disease, and putting off buying medicine to buy food. Lower FP usage was associated with higher levels of education and having a household member with cancer. Findings highlight the potential importance of measuring FP clients' degree of FP use.
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Affiliation(s)
- Christopher R. Long
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N. College Ave., Fayetteville, AR 72703 USA
| | - Marie-Rachelle Narcisse
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N. College Ave., Fayetteville, AR 72703 USA
| | - Brett Rowland
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, 1125 N. College Ave., Fayetteville, AR 72703 USA
| | - Bonnie Faitak
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, 1125 N. College Ave., Fayetteville, AR 72703 USA
| | - Mary M. Bailey
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, 1125 N. College Ave., Fayetteville, AR 72703 USA
| | - Joel Gittelsohn
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205 USA
| | - Caitlin E. Caspi
- University of Connecticut Rudd Center for Food Policy and Obesity, 1 Constitution Plaza, Hartford, CT 06103 USA
| | - Jill Niemeier
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, 1125 N. College Ave., Fayetteville, AR 72703 USA
| | - Emily S. English
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N. College Ave., Fayetteville, AR 72703 USA
| | - Pearl A. McElfish
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N. College Ave., Fayetteville, AR 72703 USA
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20
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Goode RW, Watson HJ, Masa R, Bulik CM. Prevalence and contributing factors to recurrent binge eating and obesity among black adults with food insufficiency: findings from a cross-sectional study from a nationally-representative sample. J Eat Disord 2021; 9:154. [PMID: 34823600 PMCID: PMC8620158 DOI: 10.1186/s40337-021-00509-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 11/12/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Living in a food-insecure or food insufficient household may increase risk for binge eating and obesity. Because racial disparities in food access, obesity, and access to treatment for disordered eating exist, it is important to examine these relationships in Black populations. METHODS We conducted a secondary analysis of data from the National Survey of American Life (N = 4553), a nationally-representative sample of Black Americans, including African Americans and Afro-Caribbeans. Logistic regression was used to explore the association of food insufficiency with obesity and binge eating. RESULTS In the total sample of Black Americans, the prevalence of food insufficiency was 10.9% (95% CI 10.0-11.8%). Food insufficiency was not significantly associated with obesity in Black Americans, but when associations were explored in analyses stratified by ethnicity and sex, food insufficiency significantly predicted an increased odds of obesity in Afro-Caribbeans (odds ratio [OR] = 1.47, 95% CI 1.01, 2.13). Individuals experiencing food insufficiency were more likely to report recurrent binge eating in the last 12 months (3% v 2%, P = 0.02) and a lifetime history of binge eating (6% v 3%, P = 0.004) compared to those who were food sufficient. After adjusting for socio-demographic factors, food insufficiency was not significantly associated with recurrent binge eating in Black Americans or in sex- and ethnicity-stratified analyses. CONCLUSION The present study reveals a more complex relation between food insufficiency and binge eating than previously thought-although an association existed, it was attenuated by an array of sociodemographic factors. Our results also underscore the importance of considering ethnicity as different patterns emerged between African American and Afro-Caribbean participants.
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Affiliation(s)
- Rachel W Goode
- School of Social Work, University of North Carolina at Chapel Hill, 325 Pittsboro Street, CB #3550, Chapel Hill, NC, 27599, USA.
- Department of Psychiatry, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Hunna J Watson
- Department of Psychiatry, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Discipline of Psychology, School of Population Health, Curtin University, Perth, Australia
- Division of Paediatrics, School of Medicine, University of Western Australia, Perth, Australia
| | - Rainier Masa
- School of Social Work, University of North Carolina at Chapel Hill, 325 Pittsboro Street, CB #3550, Chapel Hill, NC, 27599, USA
| | - Cynthia M Bulik
- Department of Psychiatry, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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21
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Daniel L, Hinman SJ, Harper K, Ali SH, Gu Y, Poirier L, Park R, Trujillo A, Gittelsohn J. Exploring the Reasons for Low Usage and Informing Strategies to Improve Use of a Nonprofit Grocery Store in Baltimore City. Ecol Food Nutr 2021; 60:722-736. [PMID: 33757390 DOI: 10.1080/03670244.2021.1899916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Introducing new grocery stores into low-income communities has been a focus of policy efforts to improve the food environment. Yet, evidence of the impact of this strategy on diet and health outcomes is inconsistent. In Baltimore, a not-for-profit grocery store was opened by the Salvation Army in March 2018 with the goal of improving healthy food access. Unfortunately, the store has so far failed to attract sufficient customers. This study explored the reasons for low usage from the perspective of community members and staff members. A qualitative, formative research study was conducted at the store, which included semi-structured interviews (n = 21), direct observations (n = 8), and sociodemographic surveys (n = 152). Reasons for low store usage included high prices, confusion regarding the nature of the store, and lack of product variety. Reducing prices, increasing community engagement, and using promotional materials were all recommended strategies to increase usage. The Salvation Army is interested in potentially opening other nonprofit grocery stores. The results of this study will be used to help the Salvation Army refine their nonprofit grocery store model and in their future planning.
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Affiliation(s)
- Leena Daniel
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Sarah J Hinman
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Kaitlyn Harper
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Shahmir H Ali
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Yuxuan Gu
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Lisa Poirier
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Reuben Park
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Antonio Trujillo
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Joel Gittelsohn
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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22
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Vilar-Compte M, Burrola-Méndez S, Lozano-Marrufo A, Ferré-Eguiluz I, Flores D, Gaitán-Rossi P, Teruel G, Pérez-Escamilla R. Urban poverty and nutrition challenges associated with accessibility to a healthy diet: a global systematic literature review. Int J Equity Health 2021; 20:40. [PMID: 33472636 PMCID: PMC7816472 DOI: 10.1186/s12939-020-01330-0] [Citation(s) in RCA: 65] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 11/20/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND There is an increasing global trend towards urbanization. In general, there are less food access issues in urban than rural areas, but this "urban advantage" does not benefit the poorest who face disproportionate barriers to accessing healthy food and have an increased risk of malnutrition. OBJECTIVES This systematic literature review aimed to assess urban poverty as a determinant of access to a healthy diet, and to examine the contribution of urban poverty to the nutritional status of individuals. METHODS Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) methodology, our review included quantitative and qualitative studies published in English or in Spanish between 2000 and 2019. The articles were eligible if they focused on nutrition access (i.e. access to a healthy diet) or nutrition outcomes (i.e., anemia, overweight and obesity, micronutrient deficiency, micronutrient malnutrition) among urban poor populations. Articles were excluded if they did not meet pre-established criteria. The quality of the quantitative studies was assessed by applying Khan et al.'s methodology. Similarly, we assessed the quality of qualitative articles through an adapted version of the National Institute for Health and Care Excellence (NICE) methodology checklist. Finally, we systematically analyzed all papers that met the inclusion criteria based on a qualitative content and thematic analysis. RESULTS Of the 68 papers included in the systematic review, 55 used quantitative and 13 used qualitative methods. Through the analysis of the literature we found four key themes: (i) elements that affect access to healthy eating in individuals in urban poverty, (ii) food insecurity and urban poverty, (iii) risk factors for the nutritional status of urban poor and (iv) coping strategies to limited access to food. Based on the systematization of the literature on these themes, we then proposed a conceptual framework of urban poverty and nutrition. CONCLUSIONS This systematic review identified distinct barriers posed by urban poverty in accessing healthy diets and its association with poorer nutrition outcomes, hence, questioning the "urban advantage". A conceptual framework emerging from the existing literature is proposed to guide future studies and policies. SYSTEMATIC REVIEW REGISTRATION PROSPERO Registration number: CRD42018089788 .
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Affiliation(s)
- Mireya Vilar-Compte
- Research Institute for Equitable Development EQUIDE, Universidad Iberoamericana, Prolongación Paseo de Reforma 880, Lomas de Santa Fé, 01219, Mexico City, Mexico.
| | - Soraya Burrola-Méndez
- Research Institute for Equitable Development EQUIDE, Universidad Iberoamericana, Prolongación Paseo de Reforma 880, Lomas de Santa Fé, 01219, Mexico City, Mexico
| | - Annel Lozano-Marrufo
- Research Institute for Equitable Development EQUIDE, Universidad Iberoamericana, Prolongación Paseo de Reforma 880, Lomas de Santa Fé, 01219, Mexico City, Mexico
| | - Isabel Ferré-Eguiluz
- Research Institute for Equitable Development EQUIDE, Universidad Iberoamericana, Prolongación Paseo de Reforma 880, Lomas de Santa Fé, 01219, Mexico City, Mexico
| | - Diana Flores
- Research Institute for Equitable Development EQUIDE, Universidad Iberoamericana, Prolongación Paseo de Reforma 880, Lomas de Santa Fé, 01219, Mexico City, Mexico
| | - Pablo Gaitán-Rossi
- Research Institute for Equitable Development EQUIDE, Universidad Iberoamericana, Prolongación Paseo de Reforma 880, Lomas de Santa Fé, 01219, Mexico City, Mexico
| | - Graciela Teruel
- Research Institute for Equitable Development EQUIDE, Universidad Iberoamericana, Prolongación Paseo de Reforma 880, Lomas de Santa Fé, 01219, Mexico City, Mexico
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Arlinghaus KR, Laska MN. Parent Feeding Practices in the Context of Food Insecurity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020366. [PMID: 33418887 PMCID: PMC7825020 DOI: 10.3390/ijerph18020366] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 12/28/2020] [Accepted: 01/02/2021] [Indexed: 02/06/2023]
Abstract
The process of feeding is complex and highly dependent on parent, child, social, and environmental factors. Given the rising rates of food insecurity and concomitant poor nutrition and health, the purpose of this article was to outline the important and complex ways in which the context of food insecurity can impact parent feeding practices. Key factors discussed here include the impact of food insecurity on: expectations for motherhood, structural constraints, stress and depression, parents’ perceptions of health and child weight, and intergenerational transmission of parent feeding practices. Future research needs are also identified and discussed.
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24
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Lee JW, Shin WK, Kim Y. Food Security Status is not Associated with Increased Risk of Metabolic Syndrome in Korean Adults. Metab Syndr Relat Disord 2020; 19:192-199. [PMID: 33373532 DOI: 10.1089/met.2020.0101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Background: It is still uncertain whether food insecurity increases the risk of metabolic syndrome. Recent reports from the United States and developing countries have shown conflicting results on this issue. This study aimed to investigate the association between food security status and metabolic syndrome in Korean adults. Methods: We performed a nationwide population study using data for 18,782 adults obtained from the 2012 to 2015 Korean National Health and Nutrition Examination Surveys. The 18-item Food Security Survey Module was utilized to assess household food security status. We used multiple logistic regression models to determine the association between food security status and metabolic syndrome. Results: The overall prevalence of food insecurity was 8.2% and that of metabolic syndrome was 27.3%. The prevalences of metabolic syndrome were 26.2%, 32.3%, 30.2%, and 28.8% in the high, marginal, low, and very low food security groups, respectively. Food-insecure participants (participants in the low food security and very low food security groups) were significantly more likely to be female, divorced/widowed/separated, and current smokers compared to food-secure participants. Food-insecure participants also had lower incomes, lower education attainments, and lower physical activities (P < 0.05). Compared with the high food security group, the marginal (odds ratio [OR]: 1.34, 95% confidence interval [95% CI]: 1.19-1.50, P < 0.001) and low food security groups (OR: 1.22, 95% CI: 1.04-1.42, P = 0.01) had increased odds of metabolic syndrome in the unadjusted models. However, after controlling for covariates, including age, sex, marital status, education attainment, household income, smoking, alcohol intake, and physical activity, neither marginal food security (adjusted odds ratio [aOR]: 1.02, 95% CI: 0.87-1.19, P = 0.86) nor low food security (aOR: 0.88, 95% CI: 0.71-1.08, P = 0.22) was significantly associated with an increased risk of metabolic syndrome. Conclusions: Contrary to a prior report from the United States, food security status was not significantly associated with the risk of metabolic syndrome in Korean adults.
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Affiliation(s)
- Jung Woo Lee
- Department of Human Ecology, Graduate School, Korea University, Seoul, Republic of Korea
| | - Woo-Kyoung Shin
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Yookyung Kim
- Department of Human Ecology, Graduate School, Korea University, Seoul, Republic of Korea
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25
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Willis SK, Simonsen SE, Hemmert RB, Baayd J, Digre KB, Zick CD. Food Insecurity and the Risk of Obesity, Depression, and Self-Rated Health in Women. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2020; 1:308-317. [PMID: 33786494 PMCID: PMC7784806 DOI: 10.1089/whr.2020.0049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/21/2020] [Indexed: 06/12/2023]
Abstract
Background/Introduction/Objective: Recent studies have shown that food insecurity is associated with obesity, depression, and other adverse health outcomes although little research has been focused on these relationships in underrepresented cultural and social groups. In this study we elucidate the relationship between food insecurity, community factors, dietary patterns, race/ethnicity and health among underrepresented women. Materials and Methods: The data for this investigation come from a cross-sectional survey of women drawn from five urban Utah communities of color, including African immigrants/refugees, African Americans, Hispanics, American Indians/Alaska Natives, and Pacific Islanders, and women from four rural Utah counties. Multivariate logistic regression was used to assess the relationship between food insecurity and obesity risk, self-reported depression, and self-assessed health. Results: Urban women of color were more likely to report food insecurity than rural non-Hispanic white women. Obesity and depression scores were positively associated with food insecurity. Conclusions: Utah women of color had higher levels of food insecurity than reported in state or national data, highlight an important disparity. Nutritional education initiatives, evaluating food assistance programs, and screenings in clinical settings targeting specific racial/ethnic groups may help address the disparities observed in this study.
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Affiliation(s)
- Sydney K. Willis
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Sara E. Simonsen
- College of Nursing, University of Utah, Salt Lake City, Utah, USA
| | | | - Jami Baayd
- College of Nursing, University of Utah, Salt Lake City, Utah, USA
| | - Kathleen B. Digre
- Department of Neurology and Ophthalmology and University of Utah, Salt Lake City, Utah, USA
| | - Cathleen D. Zick
- Department of Family and Consumer Studies, University of Utah, Salt Lake City, Utah, USA
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Wood AC, Blissett JM, Brunstrom JM, Carnell S, Faith MS, Fisher JO, Hayman LL, Khalsa AS, Hughes SO, Miller AL, Momin SR, Welsh JA, Woo JG, Haycraft E. Caregiver Influences on Eating Behaviors in Young Children: A Scientific Statement From the American Heart Association. J Am Heart Assoc 2020; 9:e014520. [PMID: 32389066 PMCID: PMC7660848 DOI: 10.1161/jaha.119.014520] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
A substantial body of research suggests that efforts to prevent pediatric obesity may benefit from targeting not just what a child eats, but how they eat. Specifically, child obesity prevention should include a component that addresses reasons why children have differing abilities to start and stop eating in response to internal cues of hunger and satiety, a construct known as eating self‐regulation. This review summarizes current knowledge regarding how caregivers can be an important influence on children's eating self‐regulation during early childhood. First, we discuss the evidence supporting an association between caregiver feeding and child eating self‐regulation. Second, we discuss what implications the current evidence has for actions caregivers may be able to take to support children's eating self‐regulation. Finally, we consider the broader social, economic, and cultural context around the feeding environment relationship and how this intersects with the implementation of any actions. As far as we are aware, this is the first American Heart Association (AHA) scientific statement to focus on a psychobehavioral approach to reducing obesity risk in young children. It is anticipated that the timely information provided in this review can be used not only by caregivers within the immediate and extended family but also by a broad range of community‐based care providers.
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Yan S, Caspi C, Trude ACB, Gunen B, Gittelsohn J. How Urban Food Pantries are Stocked and Food Is Distributed: Food Pantry Manager Perspectives from Baltimore. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2020. [DOI: 10.1080/19320248.2020.1729285] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Sally Yan
- International Health, Johns Hopkins School of Public Health, Baltimore, Maryland, USA
| | - Caitlin Caspi
- Family Medicine and Community Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Angela C. B. Trude
- Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Bengucan Gunen
- Health Policy and Management, Johns Hopkins School of Public Health, Baltimore, Maryland, USA
| | - Joel Gittelsohn
- International Health, Johns Hopkins School of Public Health, Baltimore, Maryland, USA
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Ebadi-Vanestanagh M, Azizi-Lalabadi M, Jahangiry L, Alizadeh M. Challenges of Food Insecurity Indicators, Diet Quality and Weight Outcomes in Women: A Cross-Sectional Study. Prev Nutr Food Sci 2020; 24:393-399. [PMID: 31915634 PMCID: PMC6941719 DOI: 10.3746/pnf.2019.24.4.393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 09/21/2019] [Indexed: 11/19/2022] Open
Abstract
Household food insecurity (FI) is a complex and multidimensional phenomenon. Despite much debate on FI, during the past decades several unaccounted aspects that are assumed to affect the FI of women still remain. Reducing the FI requires understanding its determinants. During this cross-sectional study (Jun to May of 2017), 188 women (19 ~ 64 years of age) were recruited in Sardrood-Tabriz, North-East Iran using cluster, random, and systematic sampling methods. Outcomes included socio-demographics, body compositions, anthropometric incidences, degree of FI, and five-item healthy eating scores (HES-5). Food security was classified as follows: high, marginal, low, and very low (HFS, MFS, LFS, and VLFS, respectively). Based on multiple logistic regression scores, significant relationships were found between household food security status and occupation, education level of household supervisor, number of girls and boys in the family, the household income level, and HES-5 [odds ratios (OR)=2.92; P=0.02, OR=46.57; P=0.03, OR=2.43; P=0.02, OR=2.56; P=0.005, OR=3.84; P=0.009, and OR=1.67; P<0.001, respectively], after adjusting for other factors. Influences inversely affecting diet quality and anthropometric indices may contribute to poor health status in affected women.
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Affiliation(s)
- Marziyeh Ebadi-Vanestanagh
- Student Research Center, Faculty of Nutrition, Tabriz University of Medical Sciences, Tabriz 5166614711, Iran
| | - Maryam Azizi-Lalabadi
- Research Center for Environmental Determinants of Health (RCEDH), Kermanshah University of Medical Sciences, Kermanshah 6715847141, Iran
| | - Leila Jahangiry
- Health Education and Health Promotion Department, School of Public Health, Tabriz University of Medical Sciences, Tabriz 5166614711, Iran
| | - Mohammad Alizadeh
- Nutrition Research Center, Faculty of Nutrition, Tabriz University of Medical Sciences, Tabriz 5166614711, Iran
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Abstract
PURPOSE OF REVIEW This review summarizes emerging evidence for the relationship between food insecurity and eating disorder (ED) pathology, outlines priorities for future research in this area, and comments on considerations for clinical and public health practice. RECENT FINDINGS Among adults, food insecurity is cross-sectionally associated with higher levels of overall ED pathology, binge eating, compensatory behaviors, binge-eating disorder, and bulimia nervosa. Evidence for similar relationships among adolescents has been less robust; however, compared to studies of adults, there have been substantially fewer studies conducted in adolescents to date. Emerging evidence consistently indicates that food insecurity is cross-sectionally associated with bulimic-spectrum ED pathology among adults. Findings emphasize the need for ED research to include marginalized populations who have historically been overlooked in the ED field. Much more research is needed to better understand the relationship between food insecurity and ED pathology and to determine effective ways to intervene.
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Affiliation(s)
- Vivienne M Hazzard
- Sanford Center for Biobehavioral Research, 120 Eighth Street South, Fargo, ND, 58103, USA.
| | - Katie A Loth
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Laura Hooper
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
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Intakes of energy, macronutrients and micronutrients of a population in severe food insecurity risk in Brazil. Public Health Nutr 2019; 23:649-659. [PMID: 31699161 DOI: 10.1017/s1368980019003057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
OBJECTIVE To analyse usual intakes of energy, macronutrients and micronutrients, and their percentage of inadequacy, in a Brazilian population at severe food insecurity (SFI) risk, determined from a predictive model using two national databases. DESIGN Cross-sectional study. Our study used a statistical model to predict SFI using the 2009 National Sample Household Survey, where the Brazilian Food Insecurity Scale measured SFI. SETTING Brazil. PARTICIPANTS The model was applied in a probabilistic sample of 34 003 Brazilians aged 10 years or older that participated in a national dietary survey during 2008-2009. The application of the model generated the probability of each individual being in SFI. The probability of SFI was grouped into quartiles (first quartile with the lowest SFI risk, fourth quartile with highest probability of SFI risk). RESULTS The intakes of macro- and micronutrients were associated with SFI. The amount of energy and nutrients in the diet tended to be lower among individuals in the fourth quartile, with highest probability of SFI. The average intake of all studied minerals (Ca, Fe, Na, Mg) was less in individuals in the fourth quartile. Only Na presented a higher percentage of inadequacy in the first quartile, the one with a lower chance of SFI. CONCLUSIONS The food intake of the Brazilian population at higher SFI risk is characterized by energy reduction, reduced consumption of macronutrients and high prevalence of inadequate micronutrient intakes, as well as a lower mean intakes, when compared with the first quartile with the lowest SFI risk.
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Tebeje NB, Biks GA, Abebe SM, Yesuf ME. Parent's food preference and its implication for child malnutrition in Dabat health and demographic surveillance system; community-based survey using multinomial logistic regression model: North West Ethiopia; December 2017. BMC Pediatr 2019; 19:304. [PMID: 31477091 PMCID: PMC6717982 DOI: 10.1186/s12887-019-1692-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 08/26/2019] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND A Shortage or excessive intake of the nutrient is malnutrition; affecting every aspect of human beings. Malnutrition at childhood has long-lasting and multiple effects. In Ethiopia significant numbers of children were suffering from malnutrition that might be associated with parents' food preference; the fact not yet investigated. Therefore the aim of this study was to assess parents' food preferences and its implication for child malnutrition. METHODS The study was conducted among 7150 mothers/caretakers in Dabat demographic and health surveillance site. Data were collected by experienced data collectors working for the surveillance centers after extensive training. A multinomial logistic regression model was fitted to determine the effect of factors on the dependent variable and model fitness was checked using a likelihood ratio test. RESULTS About 62.55% of mothers/caretakers prefer to feed children with a family and 16.45% of them prefer to feed children with a specific type of food. Mothers/caretakers who introduce semisolid food after 6 months 2.34(1.50-3.96) were times more likely prefer to feed with family food for their children than a balanced diet. Regarding the specific type of food preference mothers who introduce semisolid food after 6 months and those obtain food from the market were 6.53(3.80-11.24) and 4.38(3.45-5.56) times more likely to prefer to feed specific types of than balanced diet respectively. CONCLUSION Food preference had contributed to the increased and persistent magnitude of child malnutrition as 62.55% of mothers prefer to feed children with family and only 21% of them prefer to feed a balanced diet for under-five children. Therefore we recommended integration of child dietary diversity, acceptability and safety counseling session for mothers visiting health institutions for child vaccination, ANC and PNC services.
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Affiliation(s)
- Nigusie Birhan Tebeje
- School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Gashaw Andargie Biks
- Department of Health Service Management and Health Economics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Solomon Mekonnen Abebe
- Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Melike Endris Yesuf
- Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Wensel CR, Trude ACB, Poirier L, Alghamdi R, Trujillo A, Anderson Steeves E, Paige D, Gittelsohn J. B'more Healthy Corner Stores for Moms and Kids: Identifying Optimal Behavioral Economic Strategies to Increase WIC Redemptions in Small Urban Corner Stores. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 16:ijerph16010064. [PMID: 30591654 PMCID: PMC6339089 DOI: 10.3390/ijerph16010064] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 12/09/2018] [Accepted: 12/20/2018] [Indexed: 11/17/2022]
Abstract
Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) redemption rates have been declining in many low-income urban settings, potentially related to aspects of the food environment. B’more Healthy Corner Stores for Moms and Kids was a feasibility trial in Baltimore City that aimed to test multiple behavioral economic (BE) strategies in 10 corner stores (intervention = eight stores, comparison = two stores), to evaluate their influence on the stocking and redemptions of WIC foods. Tested strategies included in-person storeowner training, point of purchase promotion, product placement, and grouping of products in a display. All four strategies were feasible and implemented with high reach, dose delivered, and fidelity. Additionally, text messaging was found to be an acceptable form of intervention reinforcement for storeowners. Analyses to assess change in stocking of WIC foods, total sales of WIC foods, and sales of WIC foods to WIC clients, revealed consistent positive changes after implementation of the store owner training strategy, while changes after the implementation of other strategies were mixed. Furthermore, WIC food sales to WIC clients significantly increased after the simultaneous implementation of two strategies, compared to one (p > 0.05). Results suggest that store owner training was the most influential strategy and that the implementation of more BE strategies does not necessarily lead to proportional increases in stocking and sales. Selected BE strategies appear to be an effective way of increasing stocking and sales of WIC foods in small urban food stores.
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Affiliation(s)
- Caroline R Wensel
- Human Nutrition Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, Baltimore, MD 21205, USA.
| | - Angela C B Trude
- Human Nutrition Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, Baltimore, MD 21205, USA.
| | - Lisa Poirier
- Human Nutrition Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, Baltimore, MD 21205, USA.
| | - Riyad Alghamdi
- Human Nutrition Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, Baltimore, MD 21205, USA.
| | - Antonio Trujillo
- Health Systems Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, Baltimore, MD 21205, USA.
| | - Elizabeth Anderson Steeves
- Department of Nutrition, University of Tennessee, Knoxville, Tennessee, 1215 W. Cumberland Ave., Knoxville, TN 37996, USA.
| | - David Paige
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, Baltimore, MD 21205, USA.
| | - Joel Gittelsohn
- Human Nutrition Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, Baltimore, MD 21205, USA.
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The impact of a multilevel childhood obesity prevention intervention on healthful food acquisition, preparation, and fruit and vegetable consumption on African-American adult caregivers. Public Health Nutr 2018; 22:1300-1315. [PMID: 30463637 DOI: 10.1017/s1368980018003038] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVE To evaluate the secondary impact of a multilevel, child-focused, obesity intervention on food-related behaviours (acquisition, preparation, fruit and vegetable (FV) consumption) on youths' primary caregivers. DESIGN B'More Healthy Communities for Kids (BHCK) group-randomized controlled trial promoted access to healthy foods and food-related behaviours through wholesaler and small store strategies, peer mentor-led nutrition education aimed at youths, and social media and text messaging targeting their adult caregivers. Measures included caregivers' (n 516) self-reported household food acquisition frequency for FV, snacks and grocery items over 30 d, and usual FV consumption in a sub-sample of 226 caregivers via the NCI FV Screener. Hierarchical models assessed average treatment effects (ATE). Treatment-on-the-treated-effect (TTE) analyses evaluated correlation between behavioural change and exposure to BHCK. Exposure scores at post-assessment were based on self-reported viewing of BHCK materials and participating in activities. SETTING Thirty Baltimore City low-income neighbourhoods, USA.ParticipantsAdult caregivers of youths aged 9-15 years. RESULTS Of caregivers, 90·89 % were female; mean age 39·31 (sd 9·31) years. Baseline mean (sd) intake (servings/d) was 1·30 (1·69) fruits and 1·35 (1·05) vegetables. In ATE, no significant intervention effect was found on caregivers' food-related behaviours. In TTE, each point increase in BHCK exposure score (range: 0-6·9) increased caregivers' daily fruit consumption by 0·2 servings (0·24 (se 0·11); 95 % CI 0·04, 0·47). Caregivers reporting greater social media exposure tripled their daily fruit intake (3·16 (se 0·92); 95 % CI 1·33, 4·99) and increased their frequency of unhealthy food purchasing v. baseline. CONCLUSIONS Child-focused community-based nutrition interventions may also benefit family members' fruit intake. Child-focused interventions should involve adult caregivers and intervention effects on family members should be assessed. Future multilevel studies should consider using social media to improve reach and engage caregiver participants.
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Trude ACB, Surkan PJ, Cheskin LJ, Gittelsohn J. A multilevel, multicomponent childhood obesity prevention group-randomized controlled trial improves healthier food purchasing and reduces sweet-snack consumption among low-income African-American youth. Nutr J 2018; 17:96. [PMID: 30373597 PMCID: PMC6206663 DOI: 10.1186/s12937-018-0406-2] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Accepted: 10/17/2018] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Consumption of foods and beverages rich in sugar remains high across all races and ages in the United States. Interventions to address childhood obesity and decrease sugar intake are needed, particularly in low-income settings. METHODS B'more Healthy Communities for Kids (BHCK) was a group-randomized, controlled trial implemented among 9-15-year olds in 30 low-income areas of Baltimore. We increased access to low-sugar foods and beverages at wholesalers and small food stores. Concurrently, we encouraged their purchase and consumption by children through youth-led nutrition education in recreation centers, in-store promotions, text messaging and a social media program directed at caregivers. Sugar consumption (sugar sweetened beverage (SSB), sweets) in youth was assessed pre- (n = 534) and post-intervention (n = 401) using the Block Kids Food Frequency Questionnaire. Purchasing of 38 healthier and 28 less healthier food/beverage varieties in the previous 7 days was assessed via self-report. Multilevel models at the community and individual levels were used. Analyses were stratified by age (younger: 9-12-year olds (n = 339) vs older: 13-15 (n = 170)). Models were controlled for child's sex, race, total daily caloric intake, and caregiver's age and sex. RESULTS Overall baseline mean healthier food purchasing was 2.5 (+ 3.6; min. 0, max. 34 items per week), and unhealthier food purchasing 4.6 (+ 3.7; 0-19 items per week). Mean intake at baseline for kcal from SSB was 176 (+ 189.1) and 153 (+ 142.5), and % of calories from sweets (i.e. cookies, cakes, pies, donuts, candy, ice cream, sweetened cereals, and chocolate beverages) was 15.9 (+ 9.7) and 15.9 (+ 7.7) in comparison and intervention youth, respectively. Intervention youth increased healthier foods and beverages purchases by 1.4 more items per week than comparison youth (β = 1.4; 95% CI: 0.1; 2.8). After the intervention, there was a 3.5% decrease in kcal from sweets for older intervention youth, compared to the control group (β = - 3.5; 95% CI: -7.76; - 0.05). No impact was seen on SSB consumption. CONCLUSION BHCK successfully increased healthier food purchasing variety in youth, and decreased % calories from sweet snacks in older youth. Multilevel, multicomponent environmental childhood obesity programs are a promising strategy to improve eating behaviors among low-income urban youth. TRIAL REGISTRATION NCT02181010 (July 2, 2014, retrospectively registered).
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Affiliation(s)
- Angela C. B. Trude
- Department of International Health, Global Obesity Prevention Center, and Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205 USA
| | - Pamela J. Surkan
- Department of International Health, Social and Behavioral Interventions Program, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205 USA
| | - Lawrence J. Cheskin
- Department of Health Behavior and Society, and the Global Obesity Prevention Center, Johns Hopkins Bloomberg School of Public Health, 550 N. Broadway, Baltimore, MD 21205 USA
| | - Joel Gittelsohn
- Department of International Health, Global Obesity Prevention Center, and Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205 USA
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Costa BVDL, Freitas PPD, Menezes MCD, Guimarães LMF, Ferreira LDF, Alves MDSC, Lopes ACS. [Food environment: validation of a method for measurement and characterization in the territory with the Health Academy Program]. CAD SAUDE PUBLICA 2018; 34:e00168817. [PMID: 30208180 DOI: 10.1590/0102-311x00168817] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 04/18/2018] [Indexed: 11/22/2022] Open
Abstract
The study aimed to verify the validity of secondary data in the investigation of the food environment and to analyze the characteristics of the community environment and consumers in territories covered by a health promotion service. This was an ecological study in 18 units of the Health Academy Program in Belo Horizonte, Minas Gerais, Brazil, selected by simple cluster sampling. Validation of the establishments marketing fruits and vegetables, obtained from public databases, was done via telephone contact, Google Street View, and on-site audit. The following variables were investigated in the community food environment: type and location of the establishment; consumer's environment: availability, variety, price, and advertising of fruits and vegetables; availability and variety of ultra-processed foods; and hygienic and sanitary conditions. The access to healthy foods index was used to measure access to these foods. The on-site audit revealed weak concordance (45.7%) with the secondary databases. Of the 298 establishments, the majority were bulk grocery stores and open-air markets (61.3%), which showed the highest availability of healthy foods, but also marketed large amounts of ultra-processed foods (60.7%). One-third of the establishments showed substandard hygienic and sanitary conditions. The secondary databases showed low validity, emphasizing the need to audit the establishments. The establishments also showed a striking presence of ultra-processed foods and poor hygiene and sanitation.
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Food Insecurity Is Associated with Body Dissatisfaction among Children in California. J Acad Nutr Diet 2018; 119:1732-1737. [PMID: 30177299 DOI: 10.1016/j.jand.2018.07.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 07/05/2018] [Indexed: 11/21/2022]
Abstract
BACKGROUND Food insecurity affects 13 million children in the United States. Body dissatisfaction is also prevalent, affecting up to 46% of children. Both food insecurity and body dissatisfaction are associated with poor health outcomes, and both are associated with body weight and racial/ethnic disparities. The association between food insecurity and body dissatisfaction among children has not been examined. OBJECTIVE The purpose of this study was twofold: to examine, in a sample of children in grades 4 through 8, the relationship of child food insecurity with body dissatisfaction and to gain an understanding of the interactive roles of body mass index (BMI), race/ethnicity, and sex in the relationship between food insecurity and body dissatisfaction. DESIGN This was a cross-sectional study. PARTICIPANTS/SETTING This study examined data obtained from 14,768 children in grades 4 through 8 from 54 public schools in California between 2014 and 2016. MAIN OUTCOME MEASURES The primary outcome of interest was body dissatisfaction (five items converted to a binary indicator), and the exposure of interest was child-reported food insecurity (three items converted to a binary indicator). Subsets of validated questionnaires were used to assess body dissatisfaction and food insecurity. STATISTICAL ANALYSES PERFORMED Data were analyzed using multivariable logistic regression, and effect modification was examined by BMI category (underweight, normal, overweight, obese), race/ethnicity, and sex. RESULTS In this large and diverse sample, after adjusting for cofounders, children experiencing food insecurity, in all BMI categories and from all racial/ethnic backgrounds, had higher odds of body dissatisfaction than their food-secure counterparts. The strength of the relationship differed by BMI and race/ethnicity, with the strongest associations observed for African-American children (odds ratio=2.32; P<0.001) and children with a normal children (odds ratio=1.76; P<0.001). CONCLUSIONS Experiencing food insecurity was associated with greater body dissatisfaction, with the magnitude of the association modified by BMI and race/ethnicity.
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Vohr BR, Heyne R, Bann CM, Das A, Higgins RD, Hintz SR. Extreme Preterm Infant Rates of Overweight and Obesity at School Age in the SUPPORT Neuroimaging and Neurodevelopmental Outcomes Cohort. J Pediatr 2018; 200:132-139.e3. [PMID: 29793869 PMCID: PMC6109599 DOI: 10.1016/j.jpeds.2018.04.073] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 02/23/2018] [Accepted: 04/25/2018] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To identify rates of overweight (body mass index [BMI] ≥85th percentile) and obesity (BMI ≥95th percentile) at 6-7 years of age and associated risk factors among extremely preterm infants born at <28 weeks of gestation. STUDY DESIGN Anthropometrics, blood pressure, and active and sedentary activity levels were prospectively assessed. Three groups were compared, those with a BMI ≥85th percentile (overweight or obese for age, height, and sex) and ≥95th percentile (obese) vs <85th percentile. Multiple regression analyses estimated the relative risks of BMI ≥85th percentile and ≥95th percentile associated with perinatal and early childhood factors. RESULTS Of 388 children, 22% had a BMI of ≥85th percentile and 10% were obese. Children with obesity and overweight compared with normal weight children had higher body fat (subscapular skinfold and triceps skinfold >85th percentile), central fat (waist circumference >90th percentile), spent more time in sedentary activity (20.5 vs 18.2 vs 16.7 hours/week), and had either systolic and/or diastolic hypertension (24% vs 26% vs 14%), respectively. Postdischarge weight gain velocities from 36 weeks postmenstrual age to 18 months, and 18 months to 6-7 years were independently associated with a BMI of ≥85th percentile, whereas weight gain velocity from 18 months to 6-7 years was associated with obesity. CONCLUSIONS One in 5 former extremely preterm infants is overweight or obese and has central obesity at early school age. Postdischarge weight gain velocities were associated with overweight and obesity. These findings suggest the obesity epidemic is spreading to the most extremely preterm infants. TRIAL REGISTRATION ClinicalTrials.gov: NCT00063063 and NCT0000.
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Affiliation(s)
- Betty R Vohr
- Department of Pediatrics, Division of Neonatal Medicine, Women & Infants Hospital and Alpert Medical School of Brown University, Providence, RI.
| | - Roy Heyne
- Department of Pediatrics, Division of Neonatal Medicine, UT Southwestern, Dallas, TX
| | - Carla M Bann
- Social Statistical and Environmental Sciences Unit, RTI International, Research Triangle Park, NC
| | - Abhik Das
- Social, Statistical and Environmental Sciences Unit, RTI International, Rockville, MD
| | - Rosemary D Higgins
- National Institutes of Health and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD
| | - Susan R Hintz
- Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, CA
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Dong KR, Must A, Tang AM, Stopka TJ, Beckwith CG. Food Insecurity, Morbidities, and Substance Use in Adults on Probation in Rhode Island. J Urban Health 2018; 95:564-575. [PMID: 30030685 PMCID: PMC6095760 DOI: 10.1007/s11524-018-0290-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
When individuals are on probation, they face challenges with securing employment and safe housing due to their criminal records, which may make food access problematic. Food insecurity is a construct used as a marker for food access that considers financial constraints and has been associated with poorer health and substance use. There is limited research on the extent of food insecurity and associated morbidities and substance use among adults on probation. We conducted a cross-sectional study in 2016, surveying 304 probationers in Rhode Island to determine whether food insecurity is associated with obesity, high blood pressure, depression, and substance use. Separate logistic regression models were used to determine the associations between food insecurity and obesity, high blood pressure, depression, and substance use. Food insecurity was experienced by 70% of our study population. The estimated prevalence of high blood pressure was significantly higher in our study sample compared to the general US population. Food insecurity was not associated with obesity, high blood pressure, or current drug use in this study sample. Food insecurity was independently associated with more than three times greater odds of being depressed (AOR 3.33, 95%CI 1.89, 5.86) and a nearly twofold greater odds of self-reporting a lower health status (AOR 1.91, 95%CI 1.18, 3.10) after adjusting for gender, race/ethnicity, age, income categories, and being homeless. Probationers were found to have a higher estimated prevalence of high blood pressure and food insecurity compared to the general population, which highlights the health disparities faced by this population. Our findings have important implications for future research and interventions to decrease the health burden not only on the individuals but their families and communities.
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Affiliation(s)
- Kimberly R Dong
- Department of Public Health and Community Medicine, Tufts University School of Medicine, 136 Harrison Avenue, Boston, MA, 02111, USA.
| | - Aviva Must
- Department of Public Health and Community Medicine, Tufts University School of Medicine, 136 Harrison Avenue, Boston, MA, 02111, USA
| | - Alice M Tang
- Department of Public Health and Community Medicine, Tufts University School of Medicine, 136 Harrison Avenue, Boston, MA, 02111, USA
| | - Thomas J Stopka
- Department of Public Health and Community Medicine, Tufts University School of Medicine, 136 Harrison Avenue, Boston, MA, 02111, USA
| | - Curt G Beckwith
- The Miriam Hospital and the Alpert Medical School of Brown University, Box G-A1, Providence, Rhode Island, 02912, USA
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Webb P, Stordalen GA, Singh S, Wijesinha-Bettoni R, Shetty P, Lartey A. Hunger and malnutrition in the 21st century. BMJ 2018; 361:k2238. [PMID: 29898884 PMCID: PMC5996965 DOI: 10.1136/bmj.k2238] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Patrick Webb
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA
| | | | | | - Ramani Wijesinha-Bettoni
- Food and Agriculture Organization of the United Nations, Ringgold Standard Institution, Rome, Italy
| | - Prakash Shetty
- MS Swaminathan Research Foundation, Ringgold Standard Institution, Chennai, India
| | - Anna Lartey
- Food and Agriculture Organization of the United Nations, Ringgold Standard Institution, Rome, Italy
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Liew HP. Dietary habits and physical activity: Results from cluster analysis and market basket analysis. Nutr Health 2018; 24:83-92. [PMID: 29742963 DOI: 10.1177/0260106018770942] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND The prevalence of obesity remains a major public health concern and there has been a significant increase in childhood obesity in the USA. AIM This study seeks to uncover the major patterns of dietary habits in relation to physical activity, together with students' opinions about the quality of food in the school's cafeteria and vending machines. METHODS The empirical work of this study is based on the 2011 Healthy School Program (HSP) Evaluation. HSP assesses the demographic characteristics as well as the dietary habits and exercise patterns of a representative sample of elementary, middle, and high school students in the USA. RESULTS Findings suggest that students assigned to different clusters have different eating habits, exercise patterns, weight status, weight management, and opinions about the quality of food in the school's cafeteria and vending machines. There is great variation in dietary profiles and lifestyle behaviors among students who identified themselves as either overweight or unsure about their weight status. CONCLUSIONS Findings from this study may inform future interventions regarding how to promote student's healthy food choices when they are still in school. Health promotion initiatives should specifically target students with persistently unhealthier dietary profiles.
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Wiener RC, Sambamoorthi U, Shen C, Alwhaibi M, Findley P. Food Security and Unmet Dental Care Needs in Adults in the United States. JOURNAL OF DENTAL HYGIENE : JDH 2018; 92:14-22. [PMID: 29976789 PMCID: PMC6059372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Revised: 05/07/2018] [Accepted: 02/24/2017] [Indexed: 06/08/2023]
Abstract
Purpose: Low food security is potentially related to poor dental health and unmet dental care needs. Food security has become a significant public health concern in the United States (U.S.) since the Great Recession beginning in 2007. The purpose of this study is to determine the association between low food security and unmet dental care need in adults in the U.S.Methods: A cross-sectional design with data from the National Health and Nutrition Examination Survey (NHANES) 2011-2012 was used for the study to measure unmet dental care need. The study population included 4,845 adults, ages 20 years and above. Chi square tests and logistic regressions were conducted for the statistical analysis.Results: Overall, 47% of participants had unmet dental care need and 16% were found to have low food security. A higher percentage of adults with low food security had unmet dental care need (70.0% vs. 41.0%; p < .000) as compared to adults with full food security. In adjusted analysis, adults with low food security were more likely to have unmet dental care need as compared to participants with full food security (Adjusted Odds Ratio, 1.58 [95% CI: 1.18, 2.12; p <.01]).Conclusions: A significant association between low food security and unmet dental care need was identified among adults in the United States. Dental professionals routinely provide community educational programs and regularly query patients about food intake due to its impact on oral and overall health. It is important for dental professionals to be able to discuss community food resource options or refer patients to social service providers to assist individuals with low food security.
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Trude ACB, Kharmats AY, Jones-Smith JC, Gittelsohn J. Exposure to a multi-level multi-component childhood obesity prevention community-randomized controlled trial: patterns, determinants, and implications. Trials 2018; 19:287. [PMID: 29788977 PMCID: PMC5964684 DOI: 10.1186/s13063-018-2663-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 05/03/2018] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND For community interventions to be effective in real-world conditions, participants need to have sufficient exposure to the intervention. It is unclear how the dose and intensity of the intervention differ among study participants in low-income areas. We aimed to understand patterns of exposure to different components of a multi-level multi-component obesity prevention program to inform our future impact analyses. METHODS B'more Healthy Communities for Kids (BHCK) was a community-randomized controlled trial implemented in 28 low-income zones in Baltimore in two rounds (waves). Exposure to three different intervention components (corner store/carryout restaurants, social media/text messaging, and youth-led nutrition education) was assessed via post-intervention interviews with 385 low-income urban youths and their caregivers. Exposure scores were generated based on self-reported viewing of BHCK materials (posters, handouts, educational displays, and social media posts) and participating in activities, including taste tests during the intervention. For each intervention component, points were assigned for exposure to study materials and activities, then scaled (0-1 range), yielding an overall BHCK exposure score [youths: mean 1.1 (range 0-7.6 points); caregivers: 1.1 (0-6.7), possible highest score: 13]. Ordered logit regression analyses were used to investigate correlates of youths' and caregivers' exposure level (quartile of exposure). RESULTS Mean intervention exposure scores were significantly higher for intervention than comparison youths (mean 1.6 vs 0.5, p < 0.001) and caregivers (mean 1.6 vs 0.6, p < 0.001). However, exposure scores were low in both groups and 10% of the comparison group was moderately exposed to the intervention. For each 1-year increase in age, there was a 33% lower odds of being highly exposed to the intervention (odds ratio 0.77, 95% confidence interval 0.69; 0.88) in the unadjusted and adjusted model controlling for youths' sex and household income. CONCLUSION Treatment effects may be attenuated in community-based trials, as participants may be differentially exposed to intervention components and the comparison group may also be exposed. Exposure should be measured to provide context to impact evaluations in multi-level trials. Future analyses linking exposure scores to the outcome should control for potential confounders in the treatment-on-the-treated approach, while recognizing that confounding and selection bias may exist affecting causal inference. TRIAL REGISTRATION ClinicalTrials.gov, NCT02181010 . Retrospectively registered on 2 July 2014.
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Affiliation(s)
- Angela Cristina Bizzotto Trude
- Global Obesity Prevention Center and Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA.
| | - Anna Yevgenyevna Kharmats
- Global Obesity Prevention Center and Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Jessica C Jones-Smith
- Nutritional Sciences Program, University of Washington School of Public Health University of Washington, 353410, 306B Raitt Hall, Seattle, WA, USA
| | - Joel Gittelsohn
- Global Obesity Prevention Center and Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
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Henry JL, Trude ACB, Surkan PJ, Anderson Steeves E, Hopkins LC, Gittelsohn J. Psychosocial Determinants of Food Acquisition and Preparation in Low-Income, Urban African American Households. HEALTH EDUCATION & BEHAVIOR 2018; 45:898-907. [PMID: 29589482 DOI: 10.1177/1090198118760686] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Psychosocial factors are important determinants of health behaviors and diet-related outcomes, yet relatively little work has explored their relation to food-purchasing and preparation behaviors in low-income populations. AIM To evaluate the psychosocial factors associated with food-related behaviors. METHODS Cross-sectional data collected from 465 low-income African American adult caregivers in the baseline evaluation of the B'more Healthy Communities for Kids obesity prevention trial. Questionnaires were used to assess household sociodemographic characteristics, food sources frequently used, and food preparation and food acquisition behaviors. Multiple linear regression models explored the associations between caregiver psychosocial variables and food-related behaviors, controlling for caregivers' age, sex, household income, household size, and food assistance participation. RESULTS Caregivers purchased prepared food at carry-outs on average 3.8 times (standard deviation [ SD] = 4.6) within 30 days. Less healthy foods were acquired 2 times more frequently than healthier foods ( p < .001). Higher food-related behavioral intention and self-efficacy scores were positively associated with healthier food acquisition (β = 0.7; 95% confidence interval [CI] [0.09, 1.4]; β = 0.04; 95% CI [0.02, 0.06]) and negatively associated with frequency of purchasing at prepared food sources (β = -0.4; 95% CI [-0.6, -0.2]; β = -0.5; 95% CI [-0.7, -0.3]), respectively. Higher nutrition knowledge was associated with lower frequency of purchasing food at prepared food venues (β = -0.7; 95% CI: [-1.2, -0.2]). DISCUSSION Our findings indicate a positive association between psychosocial determinants and healthier food acquisition and food preparation behaviors. CONCLUSION Interventions that affect psychosocial factors (i.e., food-related behavioral intentions and self-efficacy) may have the potential to increase healthier food preparation and food-purchasing practices among low-income African American families.
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Affiliation(s)
| | - Angela C B Trude
- 2 Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Pamela J Surkan
- 2 Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | | | - Joel Gittelsohn
- 2 Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Depa J, Gyngell F, Müller A, Eleraky L, Hilzendegen C, Stroebele-Benschop N. Prevalence of food insecurity among food bank users in Germany and its association with population characteristics. Prev Med Rep 2018. [PMID: 29527460 PMCID: PMC5840845 DOI: 10.1016/j.pmedr.2018.01.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
The prevalence of food insecurity (FI) among food bank users in many European countries is unknown. The study aims to examine FI prevalence and associated population characteristics among this particular group of disadvantaged people in Germany. Food insecurity status was assessed among 1033 adult food bank users with a mean age of 53 years (57% female, 43% male) in Germany in 2015 using the food insecurity experience scale (FIES). About half of the participants (55.8%) were single with no children and born in Germany. Over 37% had a self-reported BMI of 30 kg/m2 or above and 37.4% indicated to smoke. Over 70% of the food bank users can be described as food insecure. Of those, about 35% were considered mildly food insecure. Almost 30% were categorized as moderately food insecure while over 7% were categorized as severely food insecure. Significant associations with food insecurity were found for gender, age, subjective health status, smoking, duration of food bank use, school education and family type. Among this socially disadvantaged population, food insecurity is highly prevalent and public health efforts should be focusing on this vulnerable population taken into account the identified population and behavioral characteristics associated with food insecurity.
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Affiliation(s)
- Julia Depa
- University of Hohenheim, Institute of Nutritional Medicine, Department of Nutritional Psychology, Fruwirthstraße 12, 70599 Stuttgart, Germany
| | - Fiona Gyngell
- University of Hohenheim, Institute of Nutritional Medicine, Department of Nutritional Psychology, Fruwirthstraße 12, 70599 Stuttgart, Germany
| | - Annalena Müller
- University of Hohenheim, Institute of Nutritional Medicine, Department of Nutritional Psychology, Fruwirthstraße 12, 70599 Stuttgart, Germany
| | - Laila Eleraky
- University of Hohenheim, Institute of Nutritional Medicine, Department of Nutritional Psychology, Fruwirthstraße 12, 70599 Stuttgart, Germany
| | - Carolin Hilzendegen
- University of Hohenheim, Institute of Nutritional Medicine, Department of Nutritional Psychology, Fruwirthstraße 12, 70599 Stuttgart, Germany
| | - Nanette Stroebele-Benschop
- University of Hohenheim, Institute of Nutritional Medicine, Department of Nutritional Psychology, Fruwirthstraße 12, 70599 Stuttgart, Germany
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Garcia MT, Sato PM, Trude ACB, Eckmann T, Steeves ETA, Hurley KM, Bógus CM, Gittelsohn J. Factors Associated with Home Meal Preparation and Fast-Food Sources Use among Low-Income Urban African American Adults. Ecol Food Nutr 2017; 57:13-31. [PMID: 29227695 DOI: 10.1080/03670244.2017.1406853] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This study aimed to assess the factors associated with home meal preparation (HMP) and fast-food sources use (FFS) frequencies of low-income African-American adults and their healthy food beliefs and attitudes, food-related psychosocial factors, food acquisition patterns, food sources use, and BMI. We used cross-sectional data from 295 adults living in Baltimore, USA. HMP was inversely associated with FFS, which had lower odds of HMP ≥1 time/day and higher BMI scores. HMP was positively associated with positive beliefs and self-efficacy toward healthy foods, getting food from healthier food sources, and lower FFS. Higher odds of HMP ≥1 time/day were associated with getting food from farmers' market and supermarkets or grocery stores. FFS had an inverse association with positive beliefs and self-efficacy toward healthy foods, and a positive association with less healthy food acquisition scores. Higher odds of FFS ≥1 time/week were associated with getting food from corner stores, sit-down restaurants, and convenience stores.
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Affiliation(s)
- Mariana T Garcia
- a Department of Politics, Management and Health , University of São Paulo , São Paulo , Brazil
| | - Priscila M Sato
- b Department of Nutrition, School of Public Health , University of São Paulo , São Paulo , Brazil
| | - Angela C B Trude
- c Global Obesity Prevention Center, Department of International Health , Johns Hopkins Bloomberg School of Public Health , Baltimore , Maryland , USA
| | - Thomas Eckmann
- c Global Obesity Prevention Center, Department of International Health , Johns Hopkins Bloomberg School of Public Health , Baltimore , Maryland , USA
| | | | - Kristen M Hurley
- e Center for Human Nutrition, Department of International Health , Johns Hopkins Bloomberg School of Public Health , Baltimore , Maryland , USA
| | - Cláudia M Bógus
- a Department of Politics, Management and Health , University of São Paulo , São Paulo , Brazil
| | - Joel Gittelsohn
- c Global Obesity Prevention Center, Department of International Health , Johns Hopkins Bloomberg School of Public Health , Baltimore , Maryland , USA
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The Impact of a Multi-Level Multi-Component Childhood Obesity Prevention Intervention on Healthy Food Availability, Sales, and Purchasing in a Low-Income Urban Area. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14111371. [PMID: 29125558 PMCID: PMC5708010 DOI: 10.3390/ijerph14111371] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 10/18/2017] [Accepted: 11/06/2017] [Indexed: 11/16/2022]
Abstract
The multifactorial causes of obesity require multilevel and multicomponent solutions, but such combined strategies have not been tested to improve the community food environment. We evaluated the impact of a multilevel (operating at different levels of the food environment) multicomponent (interventions occurring at the same level) community intervention. The B’more Healthy Communities for Kids (BHCK) intervention worked at the wholesaler (n = 3), corner store (n = 50), carryout (n = 30), recreation center (n = 28), household (n = 365) levels to improve availability, purchasing, and consumption of healthier foods and beverages (low-sugar, low-fat) in low-income food desert predominantly African American zones in the city of Baltimore (MD, USA), ultimately intending to lead to decreased weight gain in children (not reported in this manuscript). For this paper, we focus on more proximal impacts on the food environment, and measure change in stocking, sales and purchase of promoted foods at the different levels of the food system in 14 intervention neighborhoods, as compared to 14 comparison neighborhoods. Sales of promoted products increased in wholesalers. Stocking of these products improved in corner stores, but not in carryouts, and we did not find any change in total sales. Children more exposed to the intervention increased their frequency of purchase of promoted products, although improvement was not seen for adult caregivers. A multilevel food environment intervention in a low-income urban setting improved aspects of the food system, leading to increased healthy food purchasing behavior in children.
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Swindle TM, Fitzgerald S, McKelvey L, Whiteside-Mansell L. Application of Noninferiority Tests to Examine the Food Insecurity-Obesity Relationship in Children. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2017; 13:228-239. [PMID: 30906494 PMCID: PMC6428201 DOI: 10.1080/19320248.2017.1337537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
This study applies non-inferiority testing to assess the relationship between child weight and food security status in a sample of 808 children between 3 and 5 years old who were attending an urban, state-funded preschool program. Most families were African American (72.3%). Analyses were conducted using non-inferiority testing to evaluate the overweight-food security association. Odds of being overweight in the Food Insecure (FI) group were .643 (95% CI .525 to .788) while odds from the Food Secure (FS) group were .570 (95% CI .464 to .697), OR=1.127 (P=.004). These findings held across sub-groups of gender, race, and family conflict. Children whose parent indicated education beyond high school showed a reversal with FI odds of overweight less than FS odds (OR=.663). As illustrated in this study, non-inferiority testing provides an alternative analytic approach to examining the association between FI and weight in children.
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Affiliation(s)
- Taren M. Swindle
- Department of Family and Preventive Medicine, University of
Arkansas for Medical Sciences, 4301 W. Markham St, #530, Little Rock, AR 72205-7199;
United States of America
| | - Shalese Fitzgerald
- Department of Family and Preventive Medicine, University of
Arkansas for Medical Sciences, 4301 W. Markham St, #530, Little Rock, AR 72205-7199;
United States of America
| | - Lorraine McKelvey
- Department of Family and Preventive Medicine, University of
Arkansas for Medical Sciences, 4301 W. Markham St, #530, Little Rock, AR 72205-7199;
United States of America
| | - Leanne Whiteside-Mansell
- Department of Family and Preventive Medicine, University of
Arkansas for Medical Sciences, 4301 W. Markham St, #530, Little Rock, AR 72205-7199;
United States of America
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Kral TVE, Chittams J, Moore RH. Relationship between food insecurity, child weight status, and parent-reported child eating and snacking behaviors. J SPEC PEDIATR NURS 2017; 22:10.1111/jspn.12177. [PMID: 28321980 PMCID: PMC5398923 DOI: 10.1111/jspn.12177] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 12/27/2016] [Accepted: 02/07/2017] [Indexed: 12/12/2022]
Abstract
PURPOSE Prior studies showed that food insecurity may increase the odds of obesity in children and adults. We still know very little about the familial aggregation of obesity in food-insecure households or the mechanisms by which food insecurity confers an increased risk of obesity to children. The purpose of this study was to compare children and mothers from food-insecure and food-secure households in their weight status, child eating patterns/behaviors, and maternal feeding practices. DESIGN AND METHODS Fifty mothers of 8-10-year-old children were asked to complete questionnaires, including the U.S. Household Food Security survey, and had their own and their children's heights and weights measured. RESULTS The odds of a child being obese were five times higher for children from food-insecure households compared with children from food-secure households (95% confidence interval 1.15-20.8). In univariate analyses, children from food-insecure households showed significantly greater external eating, both past satiation and in the absence of hunger (p < .03), and mothers from food-insecure households expressed significantly greater concern about their children's weight and used restrictive feeding practices to a greater extent (p < .03) when compared with families from food-secure households. A greater proportion of children from food-secure households consumed three to four snacks per day (45.9 vs. 15.4%), while a higher proportion of children from food-insecure households consumed five or more snacks per day (15.4 vs. 0%; p = .02). PRACTICE IMPLICATIONS These findings provide further support for an association between food insecurity and childhood obesity and suggest that differences in external eating, child snacking patterns, and select maternal feeding practices may be implicated in food-insecure children's overconsumption of calories. When caring for food-insecure children, healthcare providers should screen for problematic eating patterns and feeding practices.
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Affiliation(s)
- Tanja V E Kral
- Department of Biobehavioral Health Sciences, University of Pennsylvania School of Nursing, Philadelphia, PA, USA.,Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Jesse Chittams
- Department of Biobehavioral Health Sciences, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Reneé H Moore
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA
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Schwendler T, Shipley C, Budd N, Trude A, Surkan PJ, Anderson Steeves E, de Morais Sato P, Eckmann T, Loh H, Gittelsohn J. Development and Implementation: B'More Healthy Communities for Kid's Store and Wholesaler Intervention. Health Promot Pract 2017; 18:822-832. [PMID: 28343413 DOI: 10.1177/1524839917696716] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Higher rates of obesity and obesity-related chronic disease are prevalent in communities where there is limited access to affordable, healthy food. The B'More Healthy Communities for Kids (BHCK) trial worked at multiple levels of the food environment including food wholesalers and corner stores to improve the surrounding community's access to healthy food. The objective of this article is to describe the development and implementation of BHCK's corner store and wholesaler interventions through formal process evaluation. Researchers evaluated each level of the intervention to assess reach, dose delivered, and fidelity. Corner store and wholesaler reach, dose delivered, and fidelity were measured by number of interactions, promotional materials distributed, and maintenance of study materials, respectively. Overall, the corner store implementation showed moderate reach, dose delivered, and high fidelity. The wholesaler intervention was implemented with high reach, dose, and fidelity. The program held 355 corner store interactive sessions and had 9,347 community member interactions, 21% of which were with children between the ages of 10 and 14 years. There was a 15% increase in corner store promoted food stocking during Wave 1 and a 17% increase during Wave 2. These findings demonstrate a successfully implemented food retailer intervention in a low-income urban setting.
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Affiliation(s)
- Teresa Schwendler
- 1 Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Cara Shipley
- 1 Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Nadine Budd
- 1 Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Angela Trude
- 1 Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Pamela J Surkan
- 1 Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | | | - Thomas Eckmann
- 1 Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Hong Loh
- 4 Johns Hopkins University, Baltimore, MD, USA
| | - Joel Gittelsohn
- 1 Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Brostow DP, Gunzburger E, Thomas KS. Food Insecurity among Veterans: Findings from the Health and Retirement Study. J Nutr Health Aging 2017; 21:1358-1364. [PMID: 29188901 DOI: 10.1007/s12603-017-0910-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES We examined the prevalence of food insecurity in an older population, specifically assessing factors associated with food insecurity among U.S. military Veterans. METHODS Data from the 2012 wave of the Health and Retirement Study and the 2013 Health Care and Nutrition Mail Survey of 2560 male participants (1254 Veterans) were used to estimate the prevalence of food insecurity and to identify significant predictors of food insecurity among male Veterans. RESULTS Among male Veterans, 6.4% reported food insecurity, compared to 11.9% of male non-veterans (p < 0.01). Younger age, difficulty with daily activities and depression were significantly associated with increased odds of food insecurity among male Veterans aged 50 to 64. In male Veterans age 65 years and older, current smoking, a psychiatric diagnosis and depression were significantly associated with increased odds of food insecurity. CONCLUSIONS This study identified significant factors that may be used to target interventions to improve nutritional status among older male Veterans.
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Affiliation(s)
- D P Brostow
- Diana P. Brostow, Denver VA Medical Center, 1055 Clermont St. Denver, CO 80220 USA,
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