Investigating food insecurity measurement globally to inform practice locally: a rapid evidence review

Is food insecurity contributing to malnutrition in older adults in Switzerland? - A cross-sectional study

Background

Food insecurity has been defined as "limited access to food, at the level of individuals or households, due to lack of money or other resources" and may increase the nutritional risk, which in turn leads to poor health, development of chronic diseases, poor psychological and cognitive functioning, and substandard academic achievements. There is limited data on the importance of food insecurity in a rich country such as Switzerland.

Methods

This is a cross-sectional analysis of data from a structured survey in an elderly population of Switzerland. The data was assessed between June and August 2021 in the course of a 7-year phone call follow-up from the EFFORT trial, which included medical inpatients at nutritional risk from 2014 to 2018. A validated questionnaire (Six-Item Short Form 2012 of the U.S: Household Food Security Survey Module) was used to assess food security status.

Results

Of the 433 included patients, 30 (6.9%) were food insecure. A significant association between food insecurity and age, governmental financial support and self-reported loneliness was found. When compared with the food secure group, there was a significant lower quality of life measured by the EQ-5D VAS.

Conclusion

In an older Swiss population of patients at nutritional risk, food insecurity was named as a contributing factor for malnutrition in about 7% of patients, particularly younger individuals with financial support, and self-reported loneliness. In the assessment of malnutrition, physician and dieticians should ask for food insecurity and if detect take appropriate actions.

Evaluation of maternal performance about food security in dietary diversity for children aged 12-24 months and its relationship with anthropometric measurements

BACKGROUND

Despite growing awareness of the problem of food security, some areas of Iran continue to experience food insecurity. The aim of the present study was to evaluate maternal performance about food security in dietary diversity for children aged between 12-24 months and its relationship with anthropometric measurements in Bushehr.

METHODS

A cross-sectional study was carried out using 400 mothers of children aged from 12 to 24 months in Bushehr selected via quota sampling. Data were collected using a reliable localized version of a 32-item food frequency questionnaire, consisting of six subscales, with a Cronbach's α: 0.81. The anthropometric measurements of height and weight were also calculated. Data analysis was performed using median, Mean±SD and multinomial logistic regression test, and odds ratio in SPSS, version 18.

RESULTS

According to standard servings, only 24% of the mothers fed their infants cereals, whereas 54.8%, 36.3%, 39.8%, and 20.3% of the mothers used meat, fruits, vegetables, and dairy products, respectively. The strongest associations were between attendance at educational classes and vegetable consumption (OR=2.09, CI=1.03-4.21), age at the onset of complementary feeding and the consumption of meat (OR=1.30, CI=1.02-1.66) and fruits (OR=1.44, CI=1.03-2.03), and the mothers' level of education and use of dairy products (OR=0.29, CI=0.09-0.90). No evidence of a significant association was found between consumption of any food groups and the anthropometric measurements.

CONCLUSIONS

Mothers in Bushehr performed poorly in providing their infants with the required nutrition with regard to dietary diversity and amount of food. However, their performance can be improved by enhancing their basic nutrition knowledge, holding practical classes on food preparation for them, and focusing on mothers with infants in high-risk groups, e.g. infants suffering from excessive weight gain, obesity, and malnutrition.

Unraveling the Channels of Food Security of the Households in Northern Kenya: Evidence from an Exclusive Dataset

Background

Most of the 10 million Kenyans lacking food security lived in the arid and semi-arid northern part of the country in a climatic condition of high temperatures and very little rainfall throughout the year. Frequent droughts had devastating effects on the livelihoods and food availability of the population.

Objectives

The objective of this study was to assess the food security status of the households in Northern Kenya and examine the factors contributing to their food security.

Methods

De-identified secondary data were used from the 2015 Feed the Future household survey conducted in 9 counties of Northern Kenya. The experience-based indicator of food security was derived from the 6-item Household Food Security Survey Module (HFSSM), which categorized sample households into 3 groups: food secure, having low food security, and having very low food security. An ordered probit model and machine learning algorithm, namely ordered random forest, were used to find the most important determinants of food security.

Results

Findings suggest that the daily per capita food expenditure, level of education of the household head, and durable asset ownership are the key predictors of food security. Households living in rural areas were likely to have low food security, but their probability of being food secure increased with at least primary education and livestock ownership, thus reflecting the importance of education and livestock production among rural communities in Northern Kenya. Access to improved water and participation in food security programs were found to be more important for food security among rural households than they were for urban households.

Conclusions

These results implied that long-term policies on improving access to education, livestock ownership, and improved water may shape the food security status of rural households in Northern Kenya.

The Diet Quality of Food-Insecure Australian Adults-A Nationally Representative Cross-Sectional Analysis

Poor diet quality exacerbates risks for acute and chronic conditions. People experiencing food insecurity have an increased likelihood of lower diet quality; however, this has not been investigated in the Australian context. The aim of this cross-sectional study was to examine whether the diet quality of Australian adults differed according to their household food security status. Data were analysed from a nationally representative sample (≥19 years; n = 9115) collected as part of the National Nutrition and Physical Activity Survey 2011-12. Household food security status and socio-demographic and health characteristics were assessed using data from an 18-module health interview. A 24 h dietary recall was used to estimate food and nutrient intakes and to calculate the Dietary Guidelines Index (DGI). DGI is a food-based score (0 to 130) that assesses adherence to the 2013 Australian Dietary Guidelines. Survey-weighted linear regression models, adjusted for age and sex, were used to examine diet quality (total DGI and component scores), and total energy and nutrient intake by food security status. Adults from food-insecure households had a mean total DGI score 3.5 points lower (95% CI -5.57, -1.46) than food-secure adults (p = 0.001). Adults from households experiencing food insecurity, when compared to those who were food-secure, had several lower DGI component scores including for dietary variety (1.6 vs. 2.3, p = 0.009), fruit (3.8 vs. 5.0, p = 0.001) and vegetables (3.7 vs. 4.4, p = 0.010). Adults from food-insecure households consumed on average more carbohydrates (45.6 vs. 43.3, p = 0.004) and total sugar (21.8 vs. 19.0, p = 0.003) as a percentage of daily energy and less protein (18.5 vs. 17.2, p = 0.004), mono-unsaturated fats (11.2 vs. 11.8, p = 0.026) as a percentage of daily energy, and fibre (20.1 vs. 23.0, p = 0.003), than food-secure adults. Sub-optimal diet may be one of the contributing factors to, or outcomes of, poorer health in food-insecure populations. Food security interventions are required to better address nutrition in food-insecure households and should be tailored to the health and socio-demographic characteristics of this population.

Food Insecurity May be an Independent Risk Factor Associated With Erectile Dysfunction in the United States: Analysis of the National Health and Nutrition Examination Survey Data

INTRODUCTION

While food insecurity is a global public health problem associated with obesity, diabetes, hypertension and coronary heart disease, literature regarding the relationship between food insecurity and erectile dysfunction (ED) is scarce.

AIM

We aimed to determine the associations between food insecurity and ED in the National Health and Nutrition Examination Survey.

METHODS

Data was extracted from 3,891 participants (aged ≥ 20 years) with ED in the 2001-2004 National Health and Nutrition Examination Survey. Multivariable logistic regression analysis with sampling weights was conducted to evaluate the associations.

MAIN OUTCOME MEASURE

Food security was assessed utilizing the Household Food Security Module. A single-question self-report from the Massachusetts Male Aging Study was utilized to evaluate ED status.

RESULTS

Approximately 10.2% of individuals had food insecurity. Food insecurity was significantly associated with ED after full adjustment (odds ratio [OR] 1.56; 95% confidence interval [95% CI] 1.16-2.09; P = .003). Men with very low food insecurity had 59% higher risks of ED compared with those having high food security (OR 1.59; 95% CI 1.13-2.27; P = .006). Moreover, the associations were stronger in the old people (age ≥ 60) (OR 2.15; 95% CI 1.26-3.66; P = .004).

CONCLUSIONS

Food insecurity might be associated with higher risks of developing ED. Wang W, Chen J, Peng L, et al. Food Insecurity May be an Independent Risk Factor Associated With Erectile Dysfunction in the United States: Analysis of the National Health and Nutrition Examination Survey Data. Sex Med 2022;XX:XXXXXX.

Households' Food Insecurity and Its Association with Demographic and Socioeconomic Factors in Gaza Strip, Palestine: A Cross-Sectional Study

Background

This sudy aimed to identify the prevalence of household's food insecurity and its association with demographic and socioeconomic factors.

Methods

A cross-sectional study was conducted in September 2021 among a representative sample of households in the Gaza strip governorates. A total of 1167 households randomly selected from all five governorates and were included in the study. The Radimer/Cornell food security scale was used to determine the prevalence and levels of household food insecurity. The household's demographic and socioeconomic characteristics were obtained using an interview-based questionnaire. Statistical analysis was performed using SPSS version 25.

Results

The overall prevalence of household's food insecurity was 71.5%. The prevalence by governorates was highest in Gaza (30.8%), followed by Khanyounis (23.0%), North-Gaza (18.6%), Middle-Area (15.2%) and Rafah (12.4%). Regarding the food insecurity levels, 333 (28.5%) of the households were food secure, 422 (36.2%) had mild food insecurity, 161 (13.8%) had moderate food insecurity, and 251 (21.5%) had severe food insecurity. Significant associations were found between governorates, monthly income, homeownership, work status with the household's food insecurity, (Crude OR [COR] = 2.02, 95% CI = [1.02–3.98], P value < 0.05), (COR = 2.00, 95% CI = [1.04–2.75], P value < 0.05), (COR = 2.36, 95% CI = [1.39–3.99], P value < 0.05), and (COR = 1.14, 95% CI = [0.66–1.97], P value < 0.05), respectively.

Conclusions

Our study demonstrates that food insecurity is highly prevalent in the Gaza strip and is associated with poor living conditions. Therefore, this high prevalence should be seriously discussed and urgently considered.

The Economic Perspective of Food Poverty and (In)security: An Analytical Approach to Measuring and Estimation in Italy

The UN Sustainable Development Goals have set clear targets on global poverty, hunger and malnutrition to be achieved by 2030, which have prompted academics and policymakers to identify useful strategies and drivers. Moreover, the COVID19 pandemic has exacerbated inequalities at national and sub-national levels thus hampering the achievement of these goals. On considering the multifaceted nature of poverty, a recent research strand focuses on food poverty and insecurity issues in terms of economic access to food and healthy diet consumption, with moderate and extreme food insecurity affecting almost 9% of the population in Europe and North America. This paper aims to analyse food poverty and insecurity at regional level in Italy. Using micro-data from the Italian Household Budget Survey carried out by ISTAT, an analytical approach was proposed to define and measure the different degree of food poverty and insecurity. Moreover, to obtain insights into whether food poverty and insecurity can afford population healthy nutrition, inequality of the distributions of food expenditure categories are estimated. The results provided us with information on other important aspects of the poverty. Indeed, in Italy individuals who are at-risk-of-food-poverty or food insecure amount to 22.3% of the entire population. Furthermore, the at-risk-of-food-poverty-rate varies at regional level from 14.6% (Umbria) to 29.6% (Abruzzo), with high levels of food consumption inequalities observed above all for vegetables, meat and fish. All these issues could help policy makers to define economic intervention policies aimed at reducing social exclusion and achieving more equitable and sustainable living conditions for the entire population.

Classification Differences in Food Insecurity Measures between the United States and Canada: Practical Implications for Trend Monitoring and Health Research

BACKGROUND

Food insecurity, inadequate access to food due to financial constraints, is a major public health issue in the United States and Canada, where the same 18-item questionnaire is used to monitor food insecurity. Researchers often assume that findings on food insecurity from the 2 countries are comparable with each other, but there are between-country differences in how food insecurity status is determined.

OBJECTIVES

We aimed to compare the distribution of household food insecurity in the Canadian population applying the US and Canadian classification schemes. We also examined the extent to which associations between food insecurity and adults' health differ under the 2 schemes.

METHODS

We used the population-representative Canadian Community Health Survey 2005-2017 linked to administrative health records. Food insecurity was measured by the Household Food Security Survey Module. Adults 18 y and older with valid food insecurity status were included from all jurisdictions except Quebec (n = 403,200). We cross-tabulated food insecurity status classified by the US and Canadian schemes. We also fitted logistic regressions on self-reported and objective health measures adjusting for confounders.

RESULTS

Applying the Canadian classification scheme, 7.7% of households were food insecure; the number fell to 6.0% with the US scheme. Associations between food insecurity status and health measures were mostly similar across classification schemes, although the associations between food insecurity and self-reported health were slightly larger if the US scheme was applied. Marginal food security/insecurity was associated with worse health measures irrespective of the classification scheme. United States-Canada discordance in classification of marginal food security/insecurity had a limited effect on health prediction.

CONCLUSIONS

United States-Canada differences in classification affected the apparent distribution of household food insecurity but not the associations between food insecurity and measures of adult health. Marginal food security/insecurity should be set apart from the food-secure group for trend monitoring and health research.

The Measurement of Food Insecurity in High-Income Countries: A Scoping Review

The measurement of food insecurity is essential to monitor the prevalence, risk factors, consequences and effects of food insecurity and the interventions and policies implemented to tackle it. Yet, how best to apply it remains an unsettled issue due to the multifaceted and context-dependent nature of food insecurity. We report a scoping review of measures of food insecurity at the individual and household level in high-income countries with the final purpose of facilitating a catalogue of instruments to be used by both researchers and practitioners. The scoping review was conducted following the methodological framework of Arksey and O'Malley and the Joanna Briggs Institute guidelines. We included all types of documents published between 2000-2020 using instruments that estimate food insecurity at both individual and household level in high-income countries, and with respondents including adolescents, adults, and elderly. We identified a total of 23 measurement strategies being used in 33 peer-reviewed publications and 114 documents from the grey literature. Our results show that most measures focus on the access dimension of food insecurity and that further research is required to develop measures that incorporate aspects of quality of dietary intake and relevant individual, household and social conditions related to food insecurity.