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Fotakis EA, Kontele I, Tzoutzou M, Grammatikopoulou MG, Arvanitaki E, Sergentanis TN, Kotrokois K, Kornarou E, Vassilakou T. Food Insecurity in Greece and across the Globe: A Narrative Literature Review. Foods 2024; 13:1579. [PMID: 38790879 PMCID: PMC11121129 DOI: 10.3390/foods13101579] [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: 03/25/2024] [Revised: 04/30/2024] [Accepted: 05/14/2024] [Indexed: 05/26/2024] Open
Abstract
Food insecurity comprises a major global public health threat, as its effects are detrimental to the mental, physical, and social aspects of the health and well-being of those experiencing it. We performed a narrative literature review on the magnitude of global food insecurity with a special emphasis on Greece and analyzed the major factors driving food insecurity, taking into consideration also the effect of the COVID-19 pandemic. An electronic search of international literature was conducted in three databases. More than 900 million people worldwide experience severe food insecurity, with future projections showing increasing trends. Within Europe, Eastern and Southern European countries display the highest food insecurity prevalence rates, with Greece reporting a prevalence of moderate or severe food insecurity ranging between 6.6% and 8% for the period 2019-2022. Climate change, war, armed conflicts and economic crises are major underlying drivers of food insecurity. Amidst these drivers, the COVID-19 pandemic had a profound impact on food insecurity levels around the globe, through halting economic growth, disrupting food supply chains and increasing unemployment and poverty. Tackling food insecurity through addressing its key drivers is essential to any progress towards succeeding the Sustainable Development Goal of "Zero Hunger".
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Affiliation(s)
- Emmanouil Alexandros Fotakis
- Department of Public Health Policy, School of Public Health, University of West Attica, 196 Alexandras Avenue, 11521 Athens, Greece; (E.A.F.); (I.K.); (E.A.); (T.N.S.); (K.K.); (E.K.)
| | - Ioanna Kontele
- Department of Public Health Policy, School of Public Health, University of West Attica, 196 Alexandras Avenue, 11521 Athens, Greece; (E.A.F.); (I.K.); (E.A.); (T.N.S.); (K.K.); (E.K.)
| | - Milia Tzoutzou
- Department of Nutrition and Dietetics, Hellenic Mediterranean University, 72300 Sitia, Greece;
| | - Maria G. Grammatikopoulou
- Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Biopolis, 41110 Larissa, Greece
| | - Eirini Arvanitaki
- Department of Public Health Policy, School of Public Health, University of West Attica, 196 Alexandras Avenue, 11521 Athens, Greece; (E.A.F.); (I.K.); (E.A.); (T.N.S.); (K.K.); (E.K.)
- Open Elderly Care Center, Municipality of Keratsini-Drapetsona, 18756 Athens, Greece
| | - Theodoros N. Sergentanis
- Department of Public Health Policy, School of Public Health, University of West Attica, 196 Alexandras Avenue, 11521 Athens, Greece; (E.A.F.); (I.K.); (E.A.); (T.N.S.); (K.K.); (E.K.)
| | - Konstantinos Kotrokois
- Department of Public Health Policy, School of Public Health, University of West Attica, 196 Alexandras Avenue, 11521 Athens, Greece; (E.A.F.); (I.K.); (E.A.); (T.N.S.); (K.K.); (E.K.)
| | - Eleni Kornarou
- Department of Public Health Policy, School of Public Health, University of West Attica, 196 Alexandras Avenue, 11521 Athens, Greece; (E.A.F.); (I.K.); (E.A.); (T.N.S.); (K.K.); (E.K.)
| | - Tonia Vassilakou
- Department of Public Health Policy, School of Public Health, University of West Attica, 196 Alexandras Avenue, 11521 Athens, Greece; (E.A.F.); (I.K.); (E.A.); (T.N.S.); (K.K.); (E.K.)
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Zhou C, Miao H, Zhao Y, Wan X. Food insecurity increases the risk of overweight and chronic diseases in adolescents: a systematic review and meta-analysis. FOOD SCIENCE AND HUMAN WELLNESS 2023. [DOI: 10.1016/j.fshw.2023.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/09/2023]
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3
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Carrillo-Álvarez E. Perspective: Food and Nutrition Insecurity in Europe: Challenges and Opportunities for Dietitians. Adv Nutr 2023; 14:995-1004. [PMID: 37543145 PMCID: PMC10509433 DOI: 10.1016/j.advnut.2023.07.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 07/23/2023] [Accepted: 07/27/2023] [Indexed: 08/07/2023] Open
Abstract
In recent years, the interest in food and nutrition insecurity in high-income countries has skyrocketed. However, its recognition in Europe is still developing. This perspective summarizes the evidence on food and nutrition insecurity across Europe in terms of prevalence, consequences, and current mitigation strategies, with the aim of outlining the challenges and opportunities for dietitians. Prevalence in the general population ranges between 5% and 20%, with higher rates identified in women, children, older adults, single-parent households, those with low educational attainment, and on low or unstable income and/or employment. In users of food aid, the prevalence of food insecurity is above 70%. Responses to food and nutrition insecurity include welfare policies and food assistance programs at regional and national levels. However, most current strategies are not successful in tackling the structural drivers of food and nutrition insecurity, nor do they guarantee diet quality. Despite limited involvement to-date, dietitians can play an important role in addressing food and nutrition insecurity across Europe. This narrative identifies 4 areas: 1) create awareness of the existence and severity of food and nutrition insecurity, 2) advocate for comprehensive, robust data on the determinants and prevalence, 3) partner with diverse stakeholders, social assistance providers, local authorities, and nongovernmental organizations in a comprehensive, intersectoral, and integrated manner, 4) participate in the development of political instruments and interventions that ensure equitable access to high-quality safe food.
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Affiliation(s)
- Elena Carrillo-Álvarez
- Public Health Specialist Network (ESDN PH), European Federation of Association of Dietetics (EFAD), Europe; Global Research on Wellbeing (GRoW) research group, Blanquerna School of Health Sciences, Universitat Ramon Lull, Barcelona, Spain.
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Does a school snack make a difference? An evaluation of the World Food Programme emergency school feeding programme in Lebanon among Lebanese and Syrian refugee children. Public Health Nutr 2022; 25:1678-1690. [PMID: 35152929 PMCID: PMC9991733 DOI: 10.1017/s1368980022000362] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To investigate the effects of providing a daily healthy school snack on children's nutritional, social and educational outcomes and explore stakeholders' perceptions of an emergency school feeding programme (SFP). DESIGN Convergence triangulation mixed-methods study design. Associations were examined between receiving the school feeding intervention and children's outcomes using multivariable regression models. Quantitative data were complemented with interviews and focus group discussions with parents and staff. SETTING In vulnerable communities in Lebanon, the World Food Programme has implemented an emergency SFP targeting Lebanese (attending morning sessions) and Syrian refugee children (attending afternoon sessions) in public schools. PARTICIPANTS Children from ten intervention schools (morning n 403; afternoon n 379) and ten matched control schools (morning n 399; afternoon n 401), as well as twenty-nine parents and twenty-two school staff members. RESULTS Diet diversity was higher in intervention schools as compared with control with a significantly higher consumption of dairy products, nuts and fruit in both sessions. Child-reported food insecurity experience was lower in children attending the afternoon session of intervention v. control schools. The SFP intervention was associated with higher school engagement and sense of school community in the morning session only. While the SFP was significantly associated with higher attendance for children in afternoon sessions only, it was significantly associated with school retention of children in both sessions. CONCLUSIONS A daily healthy snack potentially acts as an incentive to improve children's nutritional outcomes, school engagement, sense of belonging, equality between students and improvement in children's attendance and retention in public schools.
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Silva MRG, Machado-Rodrigues AM, Rodrigues D, Nogueira H, Rosado-Marques V, Gama A, Padez C. Household Food Security and Associated Factors among Portuguese Children. Ecol Food Nutr 2021; 61:407-421. [PMID: 34936530 DOI: 10.1080/03670244.2021.2018311] [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: 10/19/2022]
Abstract
This study investigated the household food insecurity (HFI) among Portuguese children following the last world financial crisis. A cross-sectional study was conducted on 4737 Portuguese children (3-11 yrs). Socio-demographics, food insecurity, and household geographic location were assessed via questionnaire. Nutritional status was measured. Following the economic crisis, 14.2% of school children and 12.0% of preschool children experienced HFI. Preschool children having parents with low and medium parental education (paternal: OR = 4.4; 95% CI 2.7-7.1 and OR = 2.4; 95% CI 1.5-3.6; maternal: OR = 2.2; 95% CI 1.4-3.5 and OR = 1.6; 95% CI 1.1-2.3), living in the south (OR = 1.4; 95% CI 1.0-2.0) and being overweight/obese (OR = 1.1; 95% CI 0.7-1.3) were more likely to experience HFI than food secure household peers. Higher OR of belonging to a food insecure household were observed in school-aged children with low and medium parental education (paternal: OR = 2.9; 95% CI 1.9-4.6 and OR = 1.7; 95% CI 1.1-2.5; maternal: OR = 2.5; 95% CI 1.6-3.9 and OR = 2.3; 95% CI 1.6-3.3), living in Coimbra (OR = 1.7; 95% CI 1.1-2.6) and being overweight/obese (OR = 1.3; 95% CI 0.8-1.5) compared to food secure household peers. Data are instructive and support the need to increase awareness of HFI, reduce its incidence in overweight/obese children from low socio-economic status families and specific geographic areas, and increase food availability based on local ecology.
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Affiliation(s)
- Maria-Raquel G Silva
- CIAS - Research Centre for Anthropology and Health - Human Biology, Health and Society, University of Coimbra, Coimbra, Portugal.,Faculty of Health Sciences, University Fernando Pessoa, Porto, Portugal.,CHRC - Comprehensive Health Research Centre-Group of Sleep, Chronobiology and Sleep Disorders-Nova Medical School, University of Lisbon, Lisbon, Portugal
| | - Aristides M Machado-Rodrigues
- CIAS - Research Centre for Anthropology and Health - Human Biology, Health and Society, University of Coimbra, Coimbra, Portugal.,High School of Education, Polytechnic Institute of Viseu, Viseu, Portugal
| | - Daniela Rodrigues
- CIAS - Research Centre for Anthropology and Health - Human Biology, Health and Society, University of Coimbra, Coimbra, Portugal.,Department of Life Sciences, University of Portugal, Coimbra, Portugal
| | - Helena Nogueira
- CIAS - Research Centre for Anthropology and Health - Human Biology, Health and Society, University of Coimbra, Coimbra, Portugal
| | - Vítor Rosado-Marques
- CIAS - Research Centre for Anthropology and Health - Human Biology, Health and Society, University of Coimbra, Coimbra, Portugal.,Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal
| | - Augusta Gama
- CIAS - Research Centre for Anthropology and Health - Human Biology, Health and Society, University of Coimbra, Coimbra, Portugal.,Department of Animal Biology, Faculty of Sciences of the University of Lisbon, Portugal
| | - Cristina Padez
- CIAS - Research Centre for Anthropology and Health - Human Biology, Health and Society, University of Coimbra, Coimbra, Portugal.,Department of Life Sciences, University of Portugal, Coimbra, Portugal
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Carrillo-Álvarez E, Salinas-Roca B, Costa-Tutusaus L, Milà-Villarroel R, Shankar Krishnan N. The Measurement of Food Insecurity in High-Income Countries: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9829. [PMID: 34574753 PMCID: PMC8468034 DOI: 10.3390/ijerph18189829] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/08/2021] [Accepted: 09/09/2021] [Indexed: 11/17/2022]
Abstract
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.
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Affiliation(s)
- Elena Carrillo-Álvarez
- Global Research on Wellbeing (GRoW) Research Group, Blanquerna School of Health Science, Ramon Llull University, Padilla, 326-332, 08025 Barcelona, Spain; (B.S.-R.); (L.C.-T.); (R.M.-V.); (N.S.K.)
| | - Blanca Salinas-Roca
- Global Research on Wellbeing (GRoW) Research Group, Blanquerna School of Health Science, Ramon Llull University, Padilla, 326-332, 08025 Barcelona, Spain; (B.S.-R.); (L.C.-T.); (R.M.-V.); (N.S.K.)
- Department of Nursing and Physiotherapy, University of Lleida, Montserrat Roig 2, 25198 Lleida, Spain
| | - Lluís Costa-Tutusaus
- Global Research on Wellbeing (GRoW) Research Group, Blanquerna School of Health Science, Ramon Llull University, Padilla, 326-332, 08025 Barcelona, Spain; (B.S.-R.); (L.C.-T.); (R.M.-V.); (N.S.K.)
| | - Raimon Milà-Villarroel
- Global Research on Wellbeing (GRoW) Research Group, Blanquerna School of Health Science, Ramon Llull University, Padilla, 326-332, 08025 Barcelona, Spain; (B.S.-R.); (L.C.-T.); (R.M.-V.); (N.S.K.)
| | - Nithya Shankar Krishnan
- Global Research on Wellbeing (GRoW) Research Group, Blanquerna School of Health Science, Ramon Llull University, Padilla, 326-332, 08025 Barcelona, Spain; (B.S.-R.); (L.C.-T.); (R.M.-V.); (N.S.K.)
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Kastorini CM, Markaki I, Tsiampalis T, Critselis E, Petralias A, Linos A. Dietary patterns and food insecurity of students participating in a food aid programme: the Mediterranean perspective. Eur J Public Health 2021; 31:143-150. [PMID: 33529326 DOI: 10.1093/eurpub/ckaa178] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND To explore the effect of household food insecurity on dietary patterns of children and adolescents participating in a school food-aid programme in regions of Greece with low socioeconomic status. METHODS A cross-sectional study was conducted during the school year 2013-14, among 406 schools in low socioeconomic status regions of Greece. Dietary habits and sociodemographic characteristics of students and their families were recorded. Factor analysis was used in order to derive children's and adolescents' dietary patterns and analysis of covariance was performed to examine the effect of households' food insecurity level on those patterns. A total of 31 399 students participated in the study; 16 652 children (5-11 years) and 14 747 adolescents (12-18 years). RESULTS Factor analysis identified five dietary patterns in both age groups, explaining the 49.1% (children) and 53.0% (adolescents) of the total variation in intake. After adjusting for various factors, the household's food insecurity was significantly associated with the majority of the derived patterns in both age groups, with most pronounced differences being observed for the consumption of red meat, poultry and fish, fruits, as well as red processed meat, cereals and dairy products, which was lower among children and adolescents with food insecurity. Children with food insecurity consumed significantly more unhealthy food, such as chips, fast food, sugared drinks, sweets, French fries and mayonnaise sauce. CONCLUSIONS Promotion of healthy eating to households facing food insecurity is of crucial importance, giving emphasis in the design of low cost, yet highly nutritious programmes.
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Affiliation(s)
| | - Ioanna Markaki
- Institute of Preventive Medicine, Environmental and Occupational Health, Prolepsis, Athens, Greece
| | - Thomas Tsiampalis
- Institute of Preventive Medicine, Environmental and Occupational Health, Prolepsis, Athens, Greece.,Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Elena Critselis
- Institute of Preventive Medicine, Environmental and Occupational Health, Prolepsis, Athens, Greece.,Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Athanassios Petralias
- Institute of Preventive Medicine, Environmental and Occupational Health, Prolepsis, Athens, Greece.,Department of Statistics, Athens University of Economics and Business, Athens, Greece
| | - Athena Linos
- Institute of Preventive Medicine, Environmental and Occupational Health, Prolepsis, Athens, Greece.,Medical School, National and Kapodistrian University of Athens, Athens, Greece
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Dalma A, Petralias A, Tsiampalis T, Nikolakopoulos S, Veloudaki A, Kastorini CM, Papadimitriou E, Zota D, Linos A. Effectiveness of a school food aid programme in improving household food insecurity; a cluster randomized trial. Eur J Public Health 2021; 30:171-178. [PMID: 31127302 DOI: 10.1093/eurpub/ckz091] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Aim of this cluster randomized trial was to examine the impact of a school feeding programme combining healthy meals provision and educational activities to reduce food insecurity. METHODS Schools participating in the DIATROFI Program in Greece during the 2014-2015 school year were randomly allocated between a multicomponent intervention (MI: each student received a daily healthy meal along with educational actions; 28 schools) and an educational intervention (EI; 23 schools). A linear-mixed model was used to examine intervention effect on change from baseline in the food insecurity score, as measured via the Food Security Survey Module (FSSM). The analysis was based on 1442 pre-post intervention questionnaire pairs in the MI group and 986 in the EI group. RESULTS The reduction in food insecurity score in the MI group was statistically significantly greater compared to the EI group, by 9.8% or -0.31 [95% confidence interval (CI) -0.61 to -0.01] FSSM units after adjusting for potential confounders. MI intervention was significantly more effective compared to EI, among students in food insecure households (mean -0.44, 95% CI -0.84 to -0.04), students in households facing hunger (mean -1.04, 95% CI -1.91 to -0.17) and overweight/obese students (mean -0.36, 95% CI -0.72 to -0.01). CONCLUSION For interventions aiming to address childhood food insecurity, public health focus should be oriented towards school-based programmes combining food assistance with activities that promote healthy nutrition.
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Affiliation(s)
- Archontoula Dalma
- Institute of Preventive Medicine, Environmental & Occupational Health, Prolepsis, Maroussi, Greece.,Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Athanassios Petralias
- Institute of Preventive Medicine, Environmental & Occupational Health, Prolepsis, Maroussi, Greece.,Department of Statistics, Athens University of Economics and Business, Athens, Greece
| | - Thomas Tsiampalis
- Institute of Preventive Medicine, Environmental & Occupational Health, Prolepsis, Maroussi, Greece
| | - Stavros Nikolakopoulos
- Institute of Preventive Medicine, Environmental & Occupational Health, Prolepsis, Maroussi, Greece.,Department of Statistics, Athens University of Economics and Business, Athens, Greece
| | - Afroditi Veloudaki
- Institute of Preventive Medicine, Environmental & Occupational Health, Prolepsis, Maroussi, Greece.,Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Eleni Papadimitriou
- Institute of Preventive Medicine, Environmental & Occupational Health, Prolepsis, Maroussi, Greece
| | - Dina Zota
- Institute of Preventive Medicine, Environmental & Occupational Health, Prolepsis, Maroussi, Greece.,Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Athena Linos
- Institute of Preventive Medicine, Environmental & Occupational Health, Prolepsis, Maroussi, Greece.,Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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Chaudhuri S, Roy M, McDonald LM, Emendack Y. Coping Behaviours and the concept of Time Poverty: a review of perceived social and health outcomes of food insecurity on women and children. Food Secur 2021. [DOI: 10.1007/s12571-021-01171-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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10
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Cohen JFW, Hecht AA, McLoughlin GM, Turner L, Schwartz MB. Universal School Meals and Associations with Student Participation, Attendance, Academic Performance, Diet Quality, Food Security, and Body Mass Index: A Systematic Review. Nutrients 2021; 13:911. [PMID: 33799780 PMCID: PMC8000006 DOI: 10.3390/nu13030911] [Citation(s) in RCA: 81] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 03/03/2021] [Accepted: 03/08/2021] [Indexed: 12/20/2022] Open
Abstract
The school environment plays an important role in children's diets and overall health, and policies for universal free school meals have the potential to contribute to positive child health outcomes. This systematic review evaluates studies examining the association between universal free school meals and students' school meal participation rates, diets, attendance, academic performance, and Body Mass Index (BMI), as well as school finances. The search was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA). A search for studies published in economically developed countries published through December 2020 was performed in PubMed, Education Resources Information Center (ERIC), Thomson Reuters' Web of Science, and Academic Search Ultimate, followed by examining the references in the resultant literature. A total of 47 studies were identified and the Newcastle-Ottawa Scale (NOS) was applied to assess bias. Nearly all studies examining universal free school meals found positive associations with school meal participation. Most studies examining universal free school meals that included free lunch found positive associations with diet quality, food security, and academic performance; however, the findings of studies examining only universal free breakfast were mixed. Research findings were similarly mixed when examining attendance as an outcome. Concerns about adverse outcomes on student BMI were not supported by the literature; in fact, several studies detected a potentially protective effect of universal free school meals on BMI. Research examining the impact of universal free meals on school finances was limited, but suggest that lower-income school districts in the U.S. may have positive financial outcomes from participation in universal free school meal provisions. Additionally, providing free meals to students may be associated with improved household incomes, particularly among lower-income families with children. Further research is needed to examine the financial implications of universal free meals for both school districts and families. Overall, universal free school meals may have multiple benefits for students and countries should consider universal free school meal provisions with strong nutrition guidelines. (PROSPERO registration: CRD42020221782).
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Affiliation(s)
- Juliana F. W. Cohen
- Department of Nutrition and Public Health, Merrimack College, 315 Turnpike Street, North Andover, MA 01845, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA
| | - Amelie A. Hecht
- Institute for Research on Poverty, University of Wisconsin-Madison, 1180 Observatory Drive, Madison, WI 53706, USA;
| | - Gabriella M. McLoughlin
- Implementation Science Center for Cancer Control and Prevention Research Center, Brown School, Washington University in St. Louis, St. Louis, MO 63130, USA;
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, Washington University in St. Louis, St. Louis, MO 63130, USA
| | - Lindsey Turner
- College of Education, Boise State University, 1910 University Drive, Boise, ID 83725-1742, USA;
| | - Marlene B. Schwartz
- Rudd Center for Food Policy and Obesity, Department of Human Development and Family Sciences, University of Connecticut, 1 Constitution Plaza, Suite 600, Hartford, CT 06103, USA;
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11
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Kanellopoulou A, Antoniou E, Notara V, Antonogeorgos G, Rojas-Gil AP, Kornilaki E, Kordoni ME, Velentza A, Mesimeri M, Lagiou A, Panagiotakos DB. Parental consumption of ultra-processed, high-fat products has no association with childhood overweight/obesity: an epidemiological study among 10-12-years-old children in Greece. Fam Pract 2021; 38:49-55. [PMID: 33269377 DOI: 10.1093/fampra/cmaa030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Overweight and obesity during childhood consist two of the most important public health issues in the 21st century. Consumption of high-fat processed food has been increased alarmingly. OBJECTIVE To examine the association between parental ultra-processed, high-fat products' consumption and childhood overweight/obesity. METHODS A cross-sectional survey, conducted among 422 children, aged 10-12 years, and their parents, during school years 2014-16. Parental and child data were collected through self-administered, anonymous and validated questionnaires. Among others, high-fat ultra-processed food consumption was also recorded. Children's weight status was based on gender- and age-specific tables derived from the International Obesity Task Force body mass index (BMI) cut-offs. RESULTS The prevalence of obesity in the reference population was 2.9%, whereas the prevalence of overweight was 19.3%. A strong correlation was observed between children's and their parents' BMI status (P < 0.001). Multi-adjusted data analysis revealed no association between parental intake of ultra-processed, high-fat products and children overweight/obesity. Similarly, when the data analysis accounted for family income and physical activity status of the children, the aforementioned results remained insignificant. CONCLUSION Despite the fact that parents' specific dietary habits seem not to affect their children's weight status, public health programs should consider parental nutrition education and mobilization as a preventive measure for childhood overweight/obesity.
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Affiliation(s)
- Aikaterini Kanellopoulou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Eleni Antoniou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Venetia Notara
- Department of Public and Community Health, School of Public Health, University of West Attica, Athens, Greece
| | - George Antonogeorgos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Andrea-Paola Rojas-Gil
- Department of Nursing, Faculty of Human Movement and Quality of Life Sciences, University of Peloponnese, Sparta, Greece
| | - Ekaterini Kornilaki
- Department of Preschool Education, School of Education, University of Crete, Rethymnon, Greece
| | - Maria-Eleni Kordoni
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Anna Velentza
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Magdalini Mesimeri
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Areti Lagiou
- Department of Public and Community Health, School of Public Health, University of West Attica, Athens, Greece
| | - Demosthenes B Panagiotakos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece.,Faculty of Health, University of Canberra, Bruce, ACT, Australia
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12
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Zaҫe D, Di Pietro ML, Reali L, de Waure C, Ricciardi W. Prevalence, socio-economic predictors and health correlates of food insecurity among Italian children- findings from a cross-sectional study. Food Secur 2020. [DOI: 10.1007/s12571-020-01111-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
AbstractConsidering food insecurity is a problem, even in developed countries, and the evidence gap regarding this issue in Italy, we aimed to assess the prevalence of food insecurity in a sample of Italian children and examine socio-economic and health correlates. This cross-sectional study was conducted in paediatric practices. Parents answered to the 18-items of the Household Food Security Module, 8 of which concern children. Paediatricians answered a questionnaire on children’s health. Socio-economic and health correlates of food insecurity in children were assessed using univariable and multivariable logistic regression. Among 573 households with children, 15·4% were food insecure, while 9·1% of children were food insecure. Socio-economic factors associated to food insecurity were living in south Italy, households with three or more children, lower household yearly income, worse economic situation description and younger parents. Food insecure children were less likely to have a normal relational [ aOR 0.31 (CI 0.11-0.85)] and physical development [aOR 0.32(CI 0.15-0.65) and had more school difficulties [aOR 3.1(CI 1.33-7.24)] compared to their food secure peers. Food insecure children had higher odds of a deterioration in their health since birth and of a worse perceived health status, as reported by their parents. Considering the results in this sample and the lack of research regarding this issues in Italy and Europe more broadly, we call for consistent, national monitoring to determine the magnitude of the problem of food insecurity in households with children in Italy and to examine the socio-economic variables and health implications in different contexts.
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Multisectoral government programs and household food insecurity: evidence from a longitudinal study in the semiarid area of northeast, Brazil. Food Secur 2020. [DOI: 10.1007/s12571-020-01100-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Food literacy programmes in secondary schools: a systematic literature review and narrative synthesis of quantitative and qualitative evidence. Public Health Nutr 2019; 22:2891-2913. [PMID: 31290384 DOI: 10.1017/s1368980019001666] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The current review aimed to synthesise the literature on food literacy interventions among adolescents in secondary schools, the attitudes and perceptions of food literacy interventions in secondary schools, and their effects on dietary outcomes. DESIGN The systematic review searched five electronic databases from the earliest record to present. SETTING The studies selected for the review were from sixteen countries: Australia (n 10), Canada (n 1), China (n 1), France (n 1), Greece (n 2), Iran (n 1), South Africa (n 1), South India (n 1), Kenya (n 1), Norway (n 2), Portugal (n 1), Denmark (n 1), Northern Ireland (n 1), USA (n 17), UK (n 1) and Sweden (n 2). PARTICIPANTS Adolescents aged 10-19 years. RESULTS Forty-four studies were eligible for inclusion. Adolescents with greater nutritional knowledge and food skills showed healthier dietary practices. Studies found a mixed association between food literacy and long-term healthy dietary behaviour. Two studies showed an improvement in adolescents' cooking skills and food safety knowledge; six studies showed an improvement in overall food safety knowledge; six studies showed an improvement in overall food and nutritional knowledge; and two studies showed an improvement in short-term healthy dietary behaviour. CONCLUSIONS Food literacy interventions conducted in a secondary-school setting have demonstrated a positive impact on healthy food and nutritional knowledge. However, there appears to be limited evidence supporting food literacy interventions and long-term dietary behaviours in adolescents. More evidence-based research is required to adequately measure all domains of food literacy and more age-specific food literacy interventions.
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Deavin N, McMahon AT, Walton K, Charlton K. ‘Breaking Barriers, Breaking Bread’: Pilot study to evaluate acceptability of a school breakfast program utilising donated food. Nutr Diet 2018; 75:500-508. [DOI: 10.1111/1747-0080.12478] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 08/16/2018] [Accepted: 08/21/2018] [Indexed: 11/26/2022]
Affiliation(s)
- Natika Deavin
- School of Medicine; University of Wollongong; Wollongong New South Wales Australia
| | - Anne-Therese McMahon
- School of Medicine; University of Wollongong; Wollongong New South Wales Australia
| | - Karen Walton
- School of Medicine; University of Wollongong; Wollongong New South Wales Australia
| | - Karen Charlton
- School of Medicine; University of Wollongong; Wollongong New South Wales Australia
- Illawarra Health and Medical Research Institute; Wollongong New South Wales Australia
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Theodoridis X, Grammatikopoulou MG, Gkiouras K, Papadopoulou SE, Agorastou T, Gkika I, Maraki MI, Dardavessis T, Chourdakis M. Food insecurity and Mediterranean diet adherence among Greek university students. Nutr Metab Cardiovasc Dis 2018; 28:477-485. [PMID: 29655531 DOI: 10.1016/j.numecd.2018.02.007] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 02/08/2018] [Accepted: 02/09/2018] [Indexed: 01/29/2023]
Abstract
AIM To assess Mediterranean diet (MD) adherence and food insecurity (FI) among university students in Greece. METHODS AND RESULTS A non-probability sample of 236 students was recruited from Athens and Thessaloniki during 2016. FI was assessed with the Household Food Insecurity Access Scale and MD adherence with the MEDAS questionnaire. Mean MEDAS score of the sample was 6.4 ± 1.9, with women demonstrating greater MD adherence compared to men (p = 0.016) and Dietetics students exhibiting increased score compared to the rest (p ≤ 0.001). A low proportion of participants were food-secure (17.8%), 45.3% were severely food-insecure, 22.0% experienced moderate FI and the remaining 14.8% had low FI. Participants studying in the city they grew up exhibited lower FI compared to those studying in other cities (p = 0.009), while, additionally, a trend was noted for increased FI among students with an unemployed family member (p = 0.05). Students working night shifts had lower MD adherence and increased FI compared to the rest (p = 0.004 and p = 0.003, respectively). The same pattern was observed among participants who smoked (p = 0.003 for MD adherence and p = 0.009 for FI, respectively). Multivariate regression analyses did not reveal any connections between FI categories, waist circumference or BMI, but showed an inverse relationship between severe FI and MD adherence. CONCLUSIONS The majority of the surveyed university students from Greece demonstrate some degree of FI, with a great proportion being severely food-insecure. Increased FI is inversely associated with MD adherence.
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Affiliation(s)
- X Theodoridis
- Department of Nutrition & Dietetics, Alexander Technological Educational Institute, Thessaloniki, Greece; Faculty of Medicine, School of Health Sciences, University of Thessaly, Larisa, Greece
| | - M G Grammatikopoulou
- Department of Nutrition & Dietetics, Alexander Technological Educational Institute, Thessaloniki, Greece; Laboratory of Hygiene, Preventive Medicine and Medical Statistics, Department of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - K Gkiouras
- Laboratory of Clinical Pharmacology, Department of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - S E Papadopoulou
- Department of Nutrition & Dietetics, Alexander Technological Educational Institute, Thessaloniki, Greece
| | - T Agorastou
- Department of Nutrition & Dietetics, Alexander Technological Educational Institute, Thessaloniki, Greece
| | - I Gkika
- Department of Nutrition & Dietetics, Alexander Technological Educational Institute, Thessaloniki, Greece
| | - M I Maraki
- Department of Nutrition & Dietetics, Harokopio University, Athens, Greece
| | - T Dardavessis
- Laboratory of Hygiene, Preventive Medicine and Medical Statistics, Department of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - M Chourdakis
- Laboratory of Hygiene, Preventive Medicine and Medical Statistics, Department of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.
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Tugault-Lafleur CN, Black JL, Barr SI. A Systematic Review of Methods to Assess Children's Diets in the School Context. Adv Nutr 2017; 8:63-79. [PMID: 28096128 PMCID: PMC5227974 DOI: 10.3945/an.116.013144] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
To evaluate the impact of school-based nutrition interventions, accurate and reliable methods are needed to assess what children eat at school. The primary objective of this study was to systematically review methodological evidence on the relative accuracy and reliability of dietary assessment methods used in the school context. The secondary objective was to assess the frequency of methods and analytical approaches used in studies reporting in-school dietary outcomes. Three health databases were searched for full-text English-language studies. Twenty-two methodological studies were reviewed. For school meal recalls, the majority of studies (n = 8 of 12) reported poor accuracy when accuracy was measured by using frequencies of misreported foods. However, when energy report rates were used as a measure of accuracy, studies suggested that children were able to accurately report energy intake as a group. Results regarding the accuracy of food-frequency questionnaires (FFQs) and food records (FRs) were promising but limited to a single study each. Meal observations offered consistently good interrater reliability across all studies reviewed (n = 11). Studies reporting in-school dietary outcomes (n = 47) used a broad range of methods, but the most frequently used methods included weighed FRs (n = 12), school meal recalls (n = 10), meal observations by trained raters (n = 8), and estimated FRs (n = 7). The range of dietary components was greater among studies relying on school meal recalls and FRs than among studies using FFQs. Overall, few studies have measured the accuracy of dietary assessment methods in the school context. Understanding the methodological characteristics associated with dietary instruments is vital for improving the quality of the evidence used to inform and evaluate the impact of school-based nutrition policies and programs.
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Affiliation(s)
- Claire N Tugault-Lafleur
- Food, Nutrition and Health, Faculty of Land and Food Systems, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jennifer L Black
- Food, Nutrition and Health, Faculty of Land and Food Systems, University of British Columbia, Vancouver, British Columbia, Canada
| | - Susan I Barr
- Food, Nutrition and Health, Faculty of Land and Food Systems, University of British Columbia, Vancouver, British Columbia, Canada
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18
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Ghodsi D, Omidvar N, Eini-Zinab H, Rashidian A, Raghfar H. Impact of the National Food Supplementary Program for Children on Household Food Security and Maternal Weight Status in Iran. Int J Prev Med 2016; 7:108. [PMID: 27833722 PMCID: PMC5036276 DOI: 10.4103/2008-7802.190605] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 08/09/2016] [Indexed: 11/20/2022] Open
Abstract
Background: Food aid programs are strategies that aim to improve nutritional status and to tackle food insecurity. This study aimed to evaluate the effect of a National Food Supplementary Program for Children on households’ food security. Methods: The study sample included 359 mothers of children aged 6–72 months under the coverage of the program in two provinces of Iran. Demographic and socioeconomic characteristics of the households and percentage of supplementary food items consumed by target child were assessed by a questionnaire and checklist. Data on household food security were collected by locally adapted Household Food Insecurity Access Scale at the baseline of the study and 6 months thereafter. Results: At the baseline, only 4.7% of families were food secure, while 43.5% were severely food insecure, and these proportions were changed to 7.9% and 38%, respectively (P < 0.001), at the end of the study. Odds of having worse food insecurity in households with medium and high wealth index was 65% and 87% lower than those with low wealth index, respectively (odds ratio [OR] = 0.35, 95% confidence interval [CI]: 0.2–0.61, and OR = 0.23, 95% CI: 0.12–0.43). Food sharing was common among more than 95% of the studied households. Mean maternal body mass index (BMI) increased significantly after 6 months (P < 0.001). However, there was no significant association between mother's BMI and household food security in the baseline and at the end of the study (P > 0.05). Conclusions: Findings show that the food supplementary program for children can also improve the household food security status. Further research is needed to assess other factors that affect the effectiveness of this kind of programs.
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Affiliation(s)
- Delaram Ghodsi
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nasrin Omidvar
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hassan Eini-Zinab
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Arash Rashidian
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; Department of Information, Evidence and Research, Eastern Mediterranean Region, World Health Organization, Cairo, Egypt
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Zota D, Dalma A, Petralias A, Lykou A, Kastorini CM, Yannakoulia M, Karnaki P, Belogianni K, Veloudaki A, Riza E, Malik R, Linos A. Promotion of healthy nutrition among students participating in a school food aid program: a randomized trial. Int J Public Health 2016; 61:583-92. [PMID: 27022997 DOI: 10.1007/s00038-016-0813-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Revised: 03/18/2016] [Accepted: 03/21/2016] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES To evaluate the potential benefits on students' eating habits, of incorporating healthy nutrition education as part of a school food aid program. METHODS 146 schools participating in the DIATROFI Program in Greece during the 2013-2014 school year were randomly allocated to the environmental intervention (received a healthy daily meal) and the multicomponent intervention (MI) group (in addition to the meal, a healthy nutrition educational program was applied). The analysis, based on 3627 pre-post intervention questionnaire pairs, was stratified for children (ages 4-11 years) and adolescents (ages 12-18 years). RESULTS Children participating in the MI group displayed 25 % higher odds of increasing the weekly consumption of milk/yoghurt and fruits, 61 % higher odds of improving BMI from overweight/obese to normal and 2.5 times higher odds of improving from underweight to normal. For adolescents in the MI group, the odds of increasing the consumption of vegetables were 40 % higher. In both intervention groups, approximately one in four overweight/obese adolescents reached normal weight. CONCLUSIONS Educational programs on healthy nutrition might be considered worth implementing in the framework of school food aid programs.
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Affiliation(s)
- Dina Zota
- Institute of Preventive Medicine, Environmental and Occupational Health, Prolepsis, Maroussi, Greece
| | - Archontoula Dalma
- Institute of Preventive Medicine, Environmental and Occupational Health, Prolepsis, Maroussi, Greece
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Athanassios Petralias
- Institute of Preventive Medicine, Environmental and Occupational Health, Prolepsis, Maroussi, Greece
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
- Department of Statistics, Athens University of Economics and Business, Athens, Greece
| | - Anastasia Lykou
- Institute of Preventive Medicine, Environmental and Occupational Health, Prolepsis, Maroussi, Greece
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Christina-Maria Kastorini
- Institute of Preventive Medicine, Environmental and Occupational Health, Prolepsis, Maroussi, Greece
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Pania Karnaki
- Institute of Preventive Medicine, Environmental and Occupational Health, Prolepsis, Maroussi, Greece
| | - Katerina Belogianni
- Institute of Preventive Medicine, Environmental and Occupational Health, Prolepsis, Maroussi, Greece
| | - Afroditi Veloudaki
- Institute of Preventive Medicine, Environmental and Occupational Health, Prolepsis, Maroussi, Greece
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Elena Riza
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Rhea Malik
- Department of Stem Cell and Regenerative Biology, Harvard University, Cambridge, MA, USA
| | - Athena Linos
- Institute of Preventive Medicine, Environmental and Occupational Health, Prolepsis, Maroussi, Greece.
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
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