To identify factors associated with the presence and severity of food insecurity among a sample of Honduran caregivers of young children.

Cross-sectional study in which the dependent variable, household food insecurity, was measured using a fourteen-item questionnaire developed and validated in a population of similar cultural context. A predictive modelling strategy used backwards elimination in logistic regression and multinomial logit regression models to compute odds ratios and 95 % confidence intervals for food insecurity.

Rural Honduras in the department of Intibucá, between March and April 2009.

Two-hundred and ninety-eight Honduran caregivers of children aged 6–18 months.

Ninety-three per cent of households were classified as having some degree of food insecurity (mild, moderate or severe). After controlling for caregiver age and marital status, compared with caregivers with more than primary-school education, those with less than primary-school education had 3·47 (95 % CI 1·34, 8·99) times the odds of severe food insecurity and 2·29 (95 % CI 1·00, 5·25) times the odds of moderate food insecurity. Our results also found that child anthropometric status was not associated with the presence or severity of food insecurity.

These results show that among the sociodemographic factors assessed, food insecurity in rural Honduras is associated with maternal education. Understanding key factors associated with food insecurity that are unique to Honduras can inform the design of interventions to effectively mitigate the negative impact of food insecurity on children.

To evaluate the association between food and nutrition insecurity and asthma in children from Latin America.

Cross-sectional study.

São Francisco do Conde, Bahia, north-eastern Brazil.

The study included 1307 children aged 6–12 years from public elementary schools. Asthma symptoms were collected using a questionnaire that was translated and adapted from the International Study of Asthma and Allergies in Childhood, phase III. The diagnosis of asthma was determined based on reports of wheezing in the previous 12 months. The Brazilian Food Insecurity Scale was used to identify food insecurity. We also obtained demographic, socio-economic and anthropometric information for each participant. We used multivariate logistic regression analyses to assess the associations of interest.

Of the children surveyed, 10·4 % had a history of wheezing and 64·5 % had some degree of food and nutrition insecurity. We found a positive dose–response relationship and statistically significant associations of asthma with moderate (OR = 1·71, 95 % CI 1·01, 2·89) and severe (OR = 2·51, 95 % CI 1·28, 4·93) food and nutrition insecurity.

The results show that moderate and severe food and nutrition insecurity are markers of vulnerability to wheezing. It is important to note that the results of studies in this field have potential implications for social policies that promote food security. Further studies to identify the mechanisms involved in the relationship between food and nutrition insecurity and asthma are needed.

To investigate the associations between sociodemographic factors and both diet indicators and food security among socio-economically disadvantaged populations in two different (national) contextual settings.

Logistic regression was used to determine cross-sectional associations between nationality, marital status, presence of children in the household, education, employment status and household income (four low income categories) with daily fruit and vegetable consumption, low-fat milk consumption and food security.

Socio-economically disadvantaged neighbourhoods in the UK and Australia.

Two samples of low-income women from disadvantaged neighbourhoods: (i) in the UK, the 2003–05 Low Income Diet and Nutrition Survey (LIDNS; n 643); and (ii) in Australia, the 2007–08 Resilience for Eating and Activity Despite Inequality (READI; n 1340).

The influence of nationality, marital status and children in the household on the dietary outcomes varied between the two nations. Obtaining greater education qualifications was the most telling factor associated with healthier dietary behaviours. Being employed was positively associated with low-fat milk consumption in both nations and with fruit consumption in the UK, while income was not associated with dietary behaviours in either nation. In Australia, the likelihood of being food secure was higher among those who were born outside Australia, married, employed or had a greater income, while higher income was the only significant factor in the UK.

The identification of factors that differently influence dietary behaviours and food security in socio-economically disadvantaged populations in the UK and Australia suggests continued efforts need to be made to ensure that interventions and policy responses are informed by the best available local evidence.

To measure and describe the prevalence and severity of household food insecurity in a remote on-reserve First Nations community using the Household Food Security Survey Module (HFSSM) and to evaluate the perceived relevance of the HFSSM for this population.

Household food security status was determined from the eighteen-item HFSSM following the classifications developed by Health Canada for the Canadian Community Health Survey, Cycle 2·2 Nutrition. One adult from each household in the community was invited to complete the HFSSM and to comment on its relevance as a tool to measure food security for First Nations communities.

Sub-Arctic Ontario, Canada.

Households (n 64).

Seventy per cent of households were food insecure, 17 % severely and 53 % moderately. The prevalence of food insecurity in households with children was 76 %. Among respondents from homes rated as having severe food insecurity, all (100 %) reported worrying that food would run out, times when food didn't last and there wasn't money to buy more, and times when they couldn't afford to eat balanced meals. The majority of respondents felt the HFSSM did not capture an accurate picture of food security for their situation. Aspects missing from the HFSSM included the high cost of market food and the incorporation of traditional food practices.

A high prevalence of household food insecurity was reported in this community. On-reserve remote First Nations communities may be more susceptible to food insecurity than off-reserve Aboriginal populations. Initiatives that promote food security for this vulnerable population are needed.

We investigated factors accounting for the consistently higher levels of household food insecurity reported by women in Canada.

Two cycles of the Canadian Community Health Survey for the years 2005/2006 and 2007/2008 were pooled to examine the association between household food insecurity, measured using the Household Food Security Survey Module and other metrics, and respondent sex. We stratified households as married/cohabiting (in which case, the household respondent was chosen randomly) or non-married (single/widowed/separated/divorced) and adjusted for differences in household characteristics, including the presence of children.

Canada.

Analysis was restricted to households dependent on employment/self-employment and whose reported annual household income was below $CAN 100 000. Exclusions included respondents less than 18 years of age, any welfare receipt, and missing food insecurity, marital status, income source and amount, or household composition data.

For non-married households, increased food insecurity in female- v. male-led households was accounted for by significant differences in household socio-economic characteristics. In contrast, in married/cohabiting households with or without children, higher food insecurity rates were reported when the respondent was female and neither respondent characteristics nor socio-economic factors accounted for the differences.

Higher rates of food insecurity in non-married households in Canada are largely attributable to women's socio-economic disadvantage. In married households, women appear to report higher levels of food insecurity than men. These findings suggest a possible bias in the measurement of population-level household food insecurity in surveys that do not account for the sex of the respondent in married/cohabiting households.

Food insecurity, lack of access to food due to financial constraints, is highly associated with poor health outcomes. Households dependent on social assistance are at increased risk of experiencing food insecurity, but food insecurity has also been reported in households reporting their main source of income from employment/wages (working households). The objective of the present study was to examine the correlates of food insecurity among households reliant on employment income.

Working households reporting food insecurity were studied through analysis of the Canadian Community Health Survey, 2007–2008, employing descriptive statistics and logistic regression. Food insecurity was measured using the Household Food Security Survey Module; all provinces participated.

Canada.

Canadian households where main income was derived through labour force participation. Social assistance recipients were excluded.

For the period 2007–2008, 4 % of working households reported food insecurity. Canadian households reliant on primary earners with less education and lower incomes were significantly more likely to experience food insecurity; these differences were accentuated across some industry sectors. Residence in Quebec was protective. Working households experiencing food insecurity were more likely to include earners reporting multiples jobs and higher job stress. Visible minority workers with comparable education levels experienced higher rates of food insecurity than European-origin workers.

Reliance on employment income does not eliminate food insecurity for a significant proportion of households, and disproportionately so for households with racialized minority workers. Increases in work stress may increase the susceptibility to poor health outcomes of workers residing in households reporting food insecurity.

To assess levels of and identify factors associated with food insecurity on the Navajo Nation.

A cross-sectional study was conducted utilizing the ten-item Radimer/Cornell food insecurity instrument. Sociodemographic, psychosocial and anthropometric data were collected.

Navajo Nation, USA.

Two hundred and seventy-six members of the Navajo Nation were randomly selected at food stores and other community locations.

Of the sample, 76·7 % had some level of food insecurity. Less education (mean years of schooling: P = 0·0001; non-completion of higher education: P = 0·0003), lower full-time employment rates (P = 0·01), and lower material style of life (P = 0·0001), food knowledge (P = 0·001) and healthy eating self-efficacy (P < 0·0001) scores were all positively associated with food insecurity. Perceived expensiveness (P < 0·0001) and perceived inconvenience (P = 0·0001) of healthy choices were also positively associated with food insecurity.

Food insecurity rates on the Navajo Nation are the highest reported to date in the USA and are likely attributable to the extremely high rates of poverty and unemployment. Reducing food insecurity on the Navajo Nation will require increasing the availability of affordable healthy foods, addressing poverty and unemployment, and providing nutrition programmes to increase demand.

In the present analysis, we seek to establish a relationship between time spent on food-related activities and food security status as well as between time spent on these activities and Supplemental Nutrition Assistance Program (SNAP, formerly called the Food Stamp Program) participation and benefit level.

After matching similar households using Coarsened Exact Matching, we estimate the relationship between food-related time, food insecurity and SNAP participation and benefit level using a comprehensive data set that combines two subsets of the Current Population Survey from years 2004–2010: the Food Security Supplement and the American Time Use Survey.

City, suburban and rural areas of the USA.

Non-institutionalized US population over the age of 15 years. Total sample size is 10 247 households.

In single households, food insecurity and SNAP participation are associated with 20 % more time in meal preparation and 13 % less time eating. Similarly, in married households, SNAP participation and benefit level are associated with 32 % less time in meal preparation while food insecurity is associated with 17 % less time eating and 14 % less time in grocery shopping.

A significant relationship exists between time spent on food-related activities and food insecurity and SNAP. This implies that federal and state government may need to consider the time constraints many low-income households face when reforming food assistance programmes.

To investigate characteristics of exposure to violence in relation to food security status among female-headed households.

Ongoing mixed-method participatory action study. Questions addressed food insecurity, public assistance, and maternal and child health. Grounded theory analysis of qualitative themes related to violence was performed. These themes were then categorized by food security status.

Homes of low-income families in Philadelphia, PA, USA.

Forty-four mothers of children under 3 years of age participating in public assistance programmes.

Forty women described exposure to violence ranging from fear of violence to personal experiences with rape. Exposure to violence affected mental health, ability to continue school and obtain work with living wages, and subsequently the ability to afford food. Exposure to violence during childhood and being a perpetrator of violence were both linked to very low food security status and depressive symptoms. Ten of seventeen (59 %) participants reporting very low food security described life-changing violence, compared with three of fifteen (20 %) participants reporting low food security and four of twelve (33 %) reporting food security. Examples of violent experiences among the very low food secure group included exposure to child abuse, neglect and rape that suggest exposure to violence is an important factor in the experience of very low food security.

Descriptions of childhood trauma and life-changing violence are linked with severe food security. Policy makers and clinicians should incorporate violence prevention efforts when addressing hunger.

The present study assessed the impact of the 2009 food packages mandated by the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) on dietary intake and home food availability in low-income African-American and Hispanic parent/child dyads.

A natural experiment was conducted to assess if the revised WIC food package altered dietary intake, home food availability, weight and various lifestyle measures immediately (6 months) following policy implementation.

Twelve WIC clinics in Chicago, IL, USA.

Two hundred and seventy-three Hispanic and African-American children aged 2–3 years, enrolled in WIC, and their mothers.

Six months after the WIC food package revisions were implemented, we observed modest changes in dietary intake. Fruit consumption increased among Hispanic mothers (mean = 0·33 servings/d, P = 0·04) and low-fat dairy intake increased among Hispanic mothers (0·21 servings/d, P = 0·02), Hispanic children (0·34 servings/d, P < 0·001) and African-American children (0·24 servings/d, P = 0·02). Home food availability of low-fat dairy and whole grains also increased. Dietary changes, however, varied by racial/ethnic group. Changes in home food availability were not significantly correlated with changes in diet.

The WIC food package revisions are one of the first efforts to modify the nutrition guidelines that govern foods provided in a federal food and nutrition assistance programme. It will be important to examine the longer-term impact of these changes on dietary intake and weight status.

In some high-income countries, a sizeable proportion of households are estimated to be food insecure. It is well known that food insecurity varies between countries and is strongly tied to household income level. The local environment may be another level of influence, which has been relatively understudied. The present review sought to synthesize and critically appraise the existing literature examining local environmental characteristics in relation to individual/household-level food insecurity in the general population.

A systematic search strategy was used to search MEDLINE, MEDLINE In-process and Other Non-indexed, EMBASE, PsychINFO, Social Services Abstracts and Sociological Abstracts databases for studies examining local place characteristic(s) in relation to self-reported food insecurity.

Studies could be experimental or observational, but had to be published in a peer-reviewed journal in French or English, and involve individuals from developed countries. ‘Place’ was defined locally, as ranging from the street to the county level.

The target population for the review included non-institutionalized individuals in the general population.

After obtaining full-text articles, eighteen primary studies met the eligibility criteria. Most studies were conducted in the USA and all but one was cross-sectional. Seven of the eleven studies that examined location of residence found that rural living was inversely associated with food insecurity. Mixed results were seen for other place measures such as social capital and distance to food stores.

Studies were heterogeneous and had various limitations that preclude definitive conclusions from being drawn. Recommendations for future research are provided.

To examine the patterns of consumption of foods high in solid fats and added sugars (SoFAS) in Brazil.

Cross-sectional study; individual dietary intake survey. Food intake was assessed by means of two non-consecutive food records. Foods providing >9·1 % of energy from saturated fat, or >1·3 % of energy from trans fat, or >13 % of energy from added sugars per 100 g were classified as high in SoFAS.

Brazilian nationwide survey, 2008–2009.

Individuals aged ≥10 years old.

Mean daily energy intake was 8037 kJ (1921 kcal), 52 % of energy came from SoFAS foods. Contribution of SoFAS foods to total energy intake was higher among women (52 %) and adolescents (54 %). Participants in rural areas (43 %) and in the lowest quartile of per capita family income (43 %) reported the smallest contribution of SoFAS foods to total energy intake. SoFAS foods were large contributors to total saturated fat (87 %), trans fat (89 %), added sugar (98 %) and total sugar (96 %) consumption. The SoFAS food groups that contributed most to total energy intake were meats and beverages. Top SoFAS foods contributing to saturated fat and trans fat intakes were meats and fats and oils. Most of the added and total sugar in the diet was supplied by SoFAS beverages and sweets and desserts.

SoFAS foods play an important role in the Brazilian diet. The study identifies options for improving the Brazilian diet and reducing nutrition-related non-communicable chronic diseases, but also points out some limitations of the nutrient-based criteria.

We aimed to assess the prevalence and associated factors of vitamin D deficiency in healthy adolescents and to determine parent–adolescent association in vitamin D status.

A cross-sectional study.

Data from the Korean National Health and Nutrition Examination Survey (KNHANES) 2008–2009. Serum 25-hydroxyvitamin D (25(OH)D) levels were measured using 125I-labelled RIA kits. Vitamin D deficiency in adolescents was defined as 25(OH)D level <27·5 nmol/l, and 25(OH)D levels between 27·5 and <50 nmol/l were considered insufficient. For the parents, vitamin D deficiency was defined as 25(OH)D level <50 nmol/l.

The study population consisted of 2062 adolescents (1095 boys, 967 girls; aged 10–18 years) and their parents (1005 fathers, 1341 mothers).

Overall, 13·4 % of adolescents (boys 11·7 %, girls 15·4 %) were 25(OH)D deficient, 54·7 % were 25(OH)D insufficient. Prevalence of vitamin D deficiency increased with age (P < 0·0001). Parental vitamin D deficiency was more prevalent in vitamin D-deficient adolescents than in non-deficient adolescents (all P < 0·0001). In multivariate logistic regression analyses, predictors for vitamin D deficiency were senior high school students (OR = 3·45–4·33), winter/spring season (OR = 3·18–5·11/5·35–7·36) and parental vitamin D deficiency (OR = 1·78–4·88; all P < 0·05).

Vitamin D insufficiency is prevalent among healthy Korean adolescents and the parent–offspring association warrants vitamin D screening for family members of deficient individuals.

To develop an FFQ for estimating culture-specific maize intake that can distinguish between home-grown and commercial maize. Home-grown maize is more likely to be contaminated with fumonisins, mycotoxins that are associated with increased risk of oesophageal cancer.

An existing FFQ developed for use in urban Xhosa populations was used as the initial framework for the maize-specific FFQ (M-FFQ). The existing questionnaire contained 126 food items divided into ten food groups (bread, cereals, vegetables, fruit, meat, dairy, snacks, condiments, beverages and fat). The M-FFQ was developed based on additional data obtained from a literature search, 24 h recalls (n 159), in-depth interviews (n 4), focus group discussions (n 56) and expert consultation. Food items available in local shops (n 3) were compared with information obtained from focus group discussions.

Five villages in two rural isiXhosa-speaking areas of the Eastern Cape Province, known to have a high incidence of oesophageal cancer, were randomly selected.

Women aged 18–55 years were recruited by snowball sampling and invited to participate.

The final M-FFQ comprised twenty-one maize-based food items, including traditional Xhosa dishes and beverages. The questionnaire focused on maize-specific dishes and distinguished between home-grown maize and commercial maize consumption.

A culturally specific dietary assessment method was designed to determine maize consumption and therefore fumonisin exposure. The questionnaire will be tested against 24 h recalls and other methods to determine its validity, after which it will be used in various epidemiological studies to determine fumonisin exposure.

To evaluate the validity of food photographs used to support the reporting of food intake with an FFQ designed for adolescents from Rio de Janeiro, Brazil.

A set of ninety-five food photographs was elaborated. The photographs’ evaluation process included the acknowledgement of foods and portions in the pictures. In the identification of foods (ninety-five photographs) and typical portions (twelve photographs), the adolescents were requested to answer a structured questionnaire related to the food photographs. The identification of the portion size of amorphous foods (forty-three photographs) was performed using three different portion sizes of actual preparations. The proportions (and 95 % confidence intervals) of adolescents who correctly identified foods and portion size in each photograph were estimated.

A public school in Niterói, Rio de Janeiro State, Brazil.

Sixty-two adolescents between 11·0 and 18·9 years old, randomly selected.

At least 90 % of adolescents correctly identified the food in ninety-two photographs and the food in the three remaining photographs was recognized by 80–89 % of the adolescents. At least 98 % of the adolescents correctly identified eleven typical or natural portions in the food photographs. For amorphous foods, at least 70 % of teenagers correctly identified the portion size in the photograph of thirty-one foods; for the other photographs, the portion size was correctly recognized by 50–69 % of the adolescents for eight foods and by less than 50 % of adolescents for four foods.

The analysed photographs are appropriate visual aids to the reporting of food consumption by adolescents.

To examine the types of food served at family dinner in the homes of adolescents and correlations with parent and family sociodemographic characteristics, psychosocial factors and meal-specific variables.

A cross-sectional population-based survey completed by mail or telephone by parents participating in Project F-EAT (Families and Eating and Activity in Teens) in 2009–2010.

Homes of families with adolescents in Minneapolis/St. Paul urban area, MN, USA.

Participants included 1923 parents/guardians (90·8 % female; 68·5 % from ethnic/racial minorities) of adolescents who participated in EAT 2010.

Less than a third (28 %) of parents reported serving a green salad at family dinner on a regular basis, but 70 % reported regularly serving vegetables (other than potatoes). About one-fifth (21 %) of families had fast food at family dinners two or more times per week. Variables from within the sociodemographic domain (low educational attainment) psychosocial domain (high work–life stress, depressive symptoms, low family functioning) and meal-specific domain (low value of family meals, low enjoyment of cooking, low meal planning, high food purchasing barriers and fewer hours in food preparation) were associated with lower healthfulness of foods served at family dinners, in analyses adjusted for sociodemographic characteristics.

There is a need for interventions to improve the healthfulness of food served at family meals. Interventions need to be suitable for parents with low levels of education; take parent and family psychosocial factors into account; promote more positive attitudes toward family meals; and provide skills to make it easier to plan and prepare healthful family meals.

To evaluate the association of sociodemographic factors and parental food consumption with children's food intake.

A cross-sectional survey.

A population-based study with a representative sample in a metropolitan region of Rio de Janeiro, Brazil. Parents’ socio-economic variables, age and education level and children's age were obtained by face-to-face interviews. The parental food intake was assessed using an FFQ and the children's food intake was assessed using two 24 h recalls.

Children (n 366) aged 6–30 months and their parents.

The hierarchical regression analysis indicated that parents’ age was positively associated with the intake of vegetables among children (β = 0·73, 95 % CI 0·11, 1·34), while parents’ educational level was positively associated with the intake of fats (β = 3·52, 95 % CI 0·04, 7·01) and negatively associated with the intake of beans (β = −13·98, 95 % CI −27·94, −0·03). The age of the children was positively associated with the intakes of meats and eggs (β = 2·88, 95 % CI 1·55, 4·22), sugars (β = 5·08, 95 % CI 1·85, 8·30) and coffee (β = 1·77, 95 % CI 0·71, 2·84), and negatively associated with the intake of vegetables (β = −2·12, 95 % CI −3·20, −1·05). The influence of parental food intake was observed for the food groups of breads, cereals and tubers (β = 0·06, 95 % CI 0·003, 0·12), beans (β = 0·11, 95 % CI −0·003, 0·22) and fruits (β = 0·10, 95 % CI 0·03, 0·16). Unfavourable socio-economic variables were associated with intakes of breads, cereals and tubers, vegetables, fruits, meats, sugars and coffee by children.

Parental food intake is associated with children's intake of cereals, beans and fruits independent of socio-economic status.

The prevalence of obesity has increased in the last decades in the Western world. The aim of the present study was to examine the association between risk-taking behaviour in adolescence and adult obesity in men and women. Furthermore, we wished to describe social differences in obesity in Denmark.

Two population-based questionnaire studies (2004–2005 and 2006–2007) were used to collect information on weight and height, sociodemographic factors and factors regarding risk-taking behaviour during adolescence. Data were analysed using multivariate logistic regression.

Denmark.

Individuals aged 18–45 years (men: n 22 827, participation rate 71·0 %; women: n 20 870, participation rate 81·4 %).

The prevalence of overweight and obesity was respectively 37·8 % and 10·6 % in men and 20·1 % and 9·7 % in women. In both sexes, obesity was found to be associated with older age, low level of schooling and living outside the capital centre. In relation to risk-taking behaviour, young age (≤13 years) at first intercourse significantly increased the odds of being obese in adulthood (men: OR = 1·34, 95 % CI 1·04, 1·71; women: OR = 1·66, 95 % CI 1·27, 1·99). In women specifically, young age at start drinking alcohol (≤12 years) was associated with obesity.

Sociodemographic factors, in particular age, level of schooling and area of residence, are associated with obesity in both men and women. Risk-taking behaviour during adolescence seems to cluster in both obese men and obese women, however most convincingly in women.