Food insecurity is associated with diet and bone mass disparities in early adolescent males but not females in the United States

Food insecurity is associated with decreased nutrient intake and poor health and possibly low bone mass in children. The purpose of this study was to formally investigate the relationship of diet, bone mass, and food insecurity among children aged 8-19 y (n = 5270). The data used in this cross-sectional study were drawn from children participating in the NHANES 2001-2004. Data were collected from homes and NHANES mobile examination centers across the United States. Food security status was classified using the US Children's Food Security Scale and the US Household Food Security Scale. Dietary measures were quantified by 24-h dietary recall and bone mineral content (BMC) was determined with whole body DXA. Results indicated that males 8-11 y from households with food insecurity among children were 2.5 times [OR = 2.5 (95% CI = 1.1-5.8)] more likely to have fewer than the USDA Food Guide recommended servings of dairy foods, 2.3 times [OR = 2.3 (95% CI = 1.3-4.0)] more likely to have less than the estimated average requirement for calcium intake, and more likely to have a significantly lower estimated total body (P = 0.04), trunk (P = 0.05), lumbar spine (P = 0.02), pelvis (P = 0.05), and left arm (P = 0.05) BMC compared with males 8-11 y old from households with food security among children. Calcium-related dietary factors and BMC did not differ among females by food security status. These results are evidence that health disparities persist among 8- to 11-y-old, food-insecure boys. Successful interventions to improve diet and bone health and reduce food insecurity among children are a continuing need in the United States.     

Low-income women's dietary intakes are sensitive to the depletion of household resources in one month

Food insecurity affects individuals' dietary intakes, but there have been few direct examinations of changes in individuals' intakes in the context of declining resources. This study examined changes in dietary intake over 30 d following the receipt of income in a sample of low-income, predominantly food-insecure women with children. Data on 182 women who received the bulk of their income in 1 monthly check were drawn from 2 Canadian studies. Equivalent 30-d measures of adult food security were constructed from participants' responses to items on the Radimer-Cornell questionnaire or the U.S. Household Food Security Survey Module. Intake data from multiple 24-h dietary recalls collected over 1 mo were merged. Mixed linear models were used to examine relationships between women's energy, nutrient, and food intakes and the depletion in household resources over 30 d, as indicated by days since the receipt of the household's major source of income. Women's intakes of energy, milk products, and vegetables decreased significantly as the time since they received income increased. When their food security status was considered, women who were food secure or marginally insecure showed no significant within-month patterns, but significant declines in energy, carbohydrate, vitamin B-6, and fruit and vegetable intake were observed for women with moderate or severe adult food insecurity. The food intakes of women in deprived circumstances are sensitive to the decline in household resources following the receipt of a monthly check.     

Food insecurity and nutrition transition combine to affect nutrient intakes in Canadian arctic communities

Food insecurity and the nutrition transition have been noted in arctic communities. We therefore evaluated biomarkers of nutritional status and nutrient intakes by traditional food (TF) and food security status among Inuit in Canada. A cross-sectional health survey of Inuit (≥18 y) in 36 arctic communities was conducted in 2007-2008. Food security was assessed by 24-h dietary recalls using USDA questionnaires and nutrient intakes. Biomarkers included serum 25-hydroxy vitamin D [25(OH)D], hemoglobin, serum ferritin, and erythrocyte RBC fatty acids (FA). Analyses were stratified by past-day TF consumption (yes vs. no) and food security status (secure vs. insecure). Food insecurity was prevalent (62.6%) and associated with higher RBC trans-FA and lower hemoglobin levels and serum ferritin, whereas TF consumption was associated with higher serum 25(OH)D, (n-3) FA, and serum ferritin (P ≤ 0.05). In men, food insecurity was associated with lower intake of energy and energy-adjusted fiber, vitamin C, iron, zinc, and magnesium. In women, food insecurity was associated with a higher intake of carbohydrates and lower intake of fiber, dietary folate equivalent, vitamin C, iron, magnesium, calcium, and vitamin D. For both sexes, when TF was consumed, there was a higher intake of protein, protein-related micronutrients, and vitamins A and C and a lower intake of carbohydrates, saturated fat, and fiber and a lower sodium:potassium ratio (P ≤ 0.05). Nutrition transition and food insecurity are associated with a multifaceted shift in nutrient status and intakes with implications for increased risk of diet-sensitive chronic diseases.     

Associations between Food Security Status and Diet-Related Outcomes among Students at a Large,Public Midwestern University

BackgroundFood insecurity is a growing issue of concern on college campuses. While many studies have focused on predictors of food insecurity, fewer studies have examined how food insecurity affects diet and diet-related outcomes among college students.ObjectiveThe objective of this study was to examine differences in dietary intake, food and cooking agency, and body mass index (calculated as kg/m²) by food security status in a sample of college students at a large, public midwestern university.DesignWe conducted a cross-sectional online survey administered from March to June 2018.ParticipantsStudents were recruited from a random sample (n=2,000) provided by the university, which included an oversample of minority racial/ethnic students from lower-income households and first-generation students. The response rate was 43% (n=851). After excluding students with missing data, the final sample was 754 enrolled students.Main outcome measuresFood security status was measured using the US Adult Food Security Survey Module. Dietary intake was assessed using the National Cancer Institute dietary screener questionnaire. Cooking and food agency was measured using the Cooking and Food Provisioning Action Scale, a new validated questionnaire. Body mass index was calculated from self-reported height and weight.Statistical analysis performedDifferences between food security categories and diet-related outcomes were examined using generalized linear models. Models adjusted for sociodemographic covariates, such as student’s age, sex, race/ethnicity, and receipt of financial aid.ResultsCompared to students with high food security, low food security was associated with lower intake of fruits, and very low food security was associated with higher intakes of total added sugar and added sugar from sugar-sweetened beverages. Marginal and very low food security were positively associated with body mass index. Marginal, low, and very low food security were inversely associated with cooking and food agency.ConclusionsStudents with food insecurity experience diet-related challenges that could translate into health disparities over time. More research is needed to understand the longitudinal effects of food insecurity on student health and well being.     

Food insecurity is highly prevalent and predicts underweight but not overweight in adults and school children from Bogotá, Colombia

The aims of this study were to determine the sociodemographic and dietary correlates of household and child food insecurity in Bogotá, Colombia and to examine whether food insecurity is a risk factor for underweight or overweight in this population. We analyzed data from 2359 families with 2526 children 5-12 y of age who completed a cross-sectional survey conducted in 2006. The survey was representative of low- and middle-income families who had children enrolled in the public primary school system of Bogotá. We used a 16-item food insecurity scale, modified from the United States Household Food Security Survey Module, assessed children's dietary intake with a FFQ, and measured their height and weight. Mothers' anthropometry was obtained through self-report. We estimated adjusted prevalence ratios and 95% CI from binomial regression models. Household food insecurity with hunger and child food insecurity were each positively associated with maternal age, parity, and single parent status and inversely related to mean household income and number of home assets. Animal protein and snack food intake were inversely related to child food insecurity. In multivariate analyses, food-insecure children were 3 times more likely to be underweight than food-secure children (95% CI = 1.6, 5.4; P = 0.0007). Hunger in the household was significantly associated with maternal underweight. Food insecurity was not related to child stunting, child overweight, or maternal overweight. The prevalence of food insecurity in Bogotá is high and related to poverty. Food insecurity does not necessarily predict overweight in countries undergoing the nutrition transition.     

Food Insecurity Reduces the Chance of Following a Nutrient-Dense Dietary Pattern by Brazilian Adults: Insights from a Nationwide Cross-Sectional Survey

Dietary patterns derived by data-driven techniques are still scarce in the food security context and may be a useful tool to inform policymakers to promote adequate and healthy diets for vulnerable populations. We investigated the association between food security status and dietary patterns among 28,127 Brazilian adults using data from the 2017–2018 Household Budget Survey. Food security status was measured by the Brazilian Food Insecurity Scale. Food items reported in two 24 h dietary recalls were combined into food groups. Dietary patterns were derived from exploratory factor analysis, and participants were grouped according to their factor scores by K-means cluster analysis. Multiple logistic regression models were fitted to investigate the association between food security status and clusters of adherence to dietary patterns. Four dietary patterns were derived: ‘Brazilian breakfast style’ (cluster 3), ‘Brazilian Traditional staple foods’ (cluster 2), ‘Beverages, ready-to-eat and convenience foods’ (cluster 4), and ‘Fruits, vegetables, and whole grains’ (cluster 1). After adjustments, food insecurity was inversely associated with adherence to the ‘Fruits vegetables, and whole grains’ pattern (OR = 0.75, 95% CI: 0.63–0.89). Findings suggest food insecurity negatively impact the adoption of a nutrient-dense dietary pattern and highlight the critical role of policy actions in a scenario of increasing food insecurity.     

What are the determinants of food insecurity in New Zealand and does this differ for males and females?

Aims: Food insecurity is a lack of assured access to sufficient nutritious food. We aimed to investigate the demographic and socio‐economic determinants of food insecurity in New Zealand and whether these determinants vary between males and females. Methods: We used data from the longitudinal Survey of Families, Income and Employment (SoFIE) (n=18,950). Respondents were classified as food insecure if, in the past 12 months, they had to use special food grants or food banks, been forced to buy cheaper food to pay for other things, or had to go without fresh fruit and vegetables often. Logistic regression analyses were used to investigate the association of demographic and socio‐economic factors on food insecurity. Models were repeated stratifying by males and females. Results: More than 15% of the SoFIE population in NZ were food insecure in 2004/05. The prevalence of food insecurity was much greater in females (19%) than males (12%). The adjusted odds of food insecurity was significantly higher in females compared to males (OR 1.6, 95% CI 1.5–1.8). In univariate analyses, food insecurity was associated with sole parenthood, unmarried status, younger age groups, Māori and Pacific ethnicity, worse self‐rated health status, renting, being unemployed and lower socioeconomic status. Income was the strongest predictor of food insecurity in multivariate modelling (OR 4.9, 95%CI 4.0–5.9 for lowest household income quintile versus highest). The associations of demographic and socioeconomic factors with food insecurity were similar in males and females. Conclusions: Food insecurity is a timely and relevant issue, as it affects a significant number of New Zealanders. Targeted policy interventions aimed at increasing money available in households are needed.     

Food Insecurity and Food Label Comprehension among Libyan Migrants in Australia

Food security among migrants and refugees remains an international public health issue. However, research among ethnic minorities in Australia is relatively low. This study explored the factors that influence the understanding of food labelling and food insecurity among Libyan migrants in Australia. An online survey was completed by 271 Libyan migrant families. Data collection included the 18-item US Household Food Security Survey Module (for food security) and a question from the Food Standards Australia New Zealand Consumer Label Survey (for food labelling comprehension). Multivariable logistic regression modelling was utilised to identify the predictors of food label comprehension and food security. Food insecurity prevalence was 72.7% (n = 196) while 35.8% of families (n = 97) reported limited food label understanding. Household size, food store location, and food affordability were found to be significantly related to food insecurity. However, gender, private health insurance, household annual income, education, and food store type and location were found to be significantly related to food labelling comprehension. Despite the population’s high educational status and food labelling comprehension level, food insecurity remained an issue among the Libyan migrants. Policy makers should consider the incorporation of food label comprehension within a broader food security approach for migrants.     

Food stamps are associated with food security and dietary intake of inner-city preschoolers from Hartford, Connecticut

The goal of the present study was to examine the association of the Food Stamp Program with the food security and dietary intake of low-income children from Hartford, CT, who were enrolled in the Supplemental Food Program for Women, Infants, and Children (WIC). We compared the food and nutrition situation of low-income preschoolers who received food stamps (FS, n = 59) with that of those who did not receive food stamps (NFS, n = 40). Children were an average age of 2.7 +/- 0.6 y, and 95% were receiving WIC benefits at the time of the study. Groups were comparable in demographic characteristics, but the socioeconomic status of the FS group was lower than that of the NFS group (P < 0.05). Food security was assessed with the Radimer/Cornell hunger scale, and dietary intake was assessed with a single 24-h recall and a 14-item food frequency questionnaire. Multivariate analyses within the FS group indicated that a monthly duration of food stamps of <4 wk was a predictor of household food security (odds ratio 0.10, 95% confidence interval 0.02-0.56). Food stamp use was associated with above-median energy-adjusted intakes of vitamin B-6 (3.13, 1.16-8.45), folate (2.92, 1.09-7.81) and iron (3.72, 1.31-10.54). The NFS children were more likely to consume <8 mg iron/d (3.73, 1.09-12.80). These results suggest that the Food Stamp Program is associated with food security and preschoolers' micronutrient intake.     

How Is Food Insecurity Associated with Dietary Behaviors? An Analysis with Low-Income,Ethnically Diverse Participants in a Nutrition Intervention Study

Food insecurity has been associated with lower nutrient intake as well as lower intake of fruits and vegetables. However, little is known about the association of food insecurity and dietary behaviors, including food choices and preparation methods. This study examines the relationship between food insecurity and dietary behaviors of low-income adults (N = 1,874; 55% Hispanic) who completed the baseline telephone survey for a nutrition education study. From April 2003 to August 2004, data were collected on demographics and food-security status and validated dietary measures: fruit and vegetable screener and Food Habits Questionnaire were used to assess fat-related behaviors (food choices or preparation methods that lead to an increase or decrease in fat intake). χ2 tests were conducted to compare each demographic variable by food-security status. Univariate linear regression models examined dietary variables by food-security status in univariate models initially, then in multivariable models adjusting for demographics. Half of participants reported food insecurity. Food Habits Questionnaire scores were significantly greater in the food-insecure group, reflecting a higher fat intake (P < 0.05). Fruit (with juice) intake was significantly greater in the food-insecure participants reflecting increased juice intake (P < 0.05). Food-insecure individuals reported a higher juice intake and a lower frequency of fat-lowering behaviors. Future interventions with food-insecure individuals should include nutrition education as well as efforts to increase access and availability to healthier foods. Further qualitative and quantitative research is needed on the relationship between diet and food insecurity.     

Dietary Quality and Usual Intake of Underconsumed Nutrients and Related Food Groups Differ by Food Security Status for Rural,Midwestern Food Pantry Clients

BackgroundFood pantry users represent a predominantly food insecure population, yet dietary intake may differ among food secure (FS), low FS, and very low FS clients. Usual intake of food groups and nutrients by food security status has not previously been compared among food pantry clients.ObjectiveThis study aimed to estimate the usual intakes of underconsumed nutrients (ie, potassium; dietary fiber; choline; magnesium; calcium; vitamins A, D, E, and C; and iron) and related food groups (ie, vegetables, fruits, whole grains, and dairy) and dietary quality, and to evaluate their relationship with food security status.DesignThis cross-sectional, secondary analysis used baseline data from a prior intervention study (Clinical Trial Registry: NCT03566095). A demographic questionnaire, the US Household Food Security Survey Module, and up to three 24-hour dietary recalls on nonconsecutive days, including weekdays and weekends, were collected.Participants/settingThis community-based study included a convenience sample of adult, midwestern food pantry clients (N=579) recruited from August to November 2014.Main outcome measuresMain outcomes evaluated were Healthy Eating Index-2010 scores and usual intakes of underconsumed nutrients and related food groups.Statistical analyses performedLinear regression models and the National Cancer Institute method, adjusting for confounders, were used to estimate associations of food security with diet quality and usual intake, respectively.ResultsBeing FS was associated with a higher whole grains HEI-2010 score and higher mean usual intake of whole grains compared with being low FS. Being FS was associated with higher usual intakes of iron and dairy compared with being very low FS. Being FS was associated with a higher mean usual intake of dark green vegetables compared with being low FS and very low FS. Usual intakes were below federal guidance for all subgroups of food security.ConclusionsAlthough food security status may differentiate dietary intake among food pantry clients, improvements are needed among all clients.     

Food insecurity is associated with nutrient inadequacies among Canadian adults and adolescents

Household food insecurity constrains food selection, but whether the dietary compromises associated with this problem heighten the risk of nutrient inadequacies is unclear. The objectives of this study were to examine the relationship between household food security status and adults' and children's dietary intakes and to estimate the prevalence of nutrient inadequacies among adults and children, differentiating by household food security status. We analyzed 24-h recall and household food security data for persons aged 1-70 y from the 2004 Canadian Community Health Survey (cycle 2.2). The relationship between adults' and children's nutrient and food intakes and household food security status was assessed using regression analysis. Estimates of the prevalence of inadequate nutrient intakes by food security status and age/sex group were calculated using probability assessment methods. Poorer dietary intakes were observed among adolescents and adults in food-insecure households and many of the differences by food security status persisted after accounting for potential confounders in multivariate analyses. Higher estimated prevalences of nutrient inadequacy were apparent among adolescents and adults in food-insecure households, with the differences most marked for protein, vitamin A, thiamin, riboflavin, vitamin B-6, folate, vitamin B-12, magnesium, phosphorus, and zinc. Among children, few differences in dietary intakes by household food security status were apparent and there was little indication of nutrient inadequacy. This study indicates that for adults and, to some degree, adolescents, food insecurity is associated with inadequate nutrient intakes. These findings highlight the need for concerted public policy responses to ameliorate household food insecurity.     

Comparison of dietary food and nutrient intakes by supplement use in pregnant and lactating women in Seoul

This study was performed to compare the dietary food and nutrient intakes according to supplement use in pregnant and lactating women in Seoul. The subjects were composed of 201 pregnant and 104 lactating women, and their dietary food intake was assessed using the 24-h recall method. General information on demographic and socioeconomic factors, as well as health-related behaviors, including the use of dietary supplements, were collected. About 88% and 60% of the pregnant and lactating women took dietary supplements, respectively. The proportion of dietary supplements used was higher in pregnant women with a higher level of education. After adjusting for potential confounders, among the pregnant women, supplement users were found to consume 45% more vegetables, and those among the lactating women were found to consume 96% more beans and 58% more vegetables. The intakes of dietary fiber and β-carotene among supplement users were higher than those of non-users, by 23% and 39%, respectively. Among pregnant women, the proportion of women with an intake of vitamin C (from diet alone) below the estimated average requirements (EAR) was lower among supplement users [users (44%) vs. non-users (68%)], and the proportion of lactating women with intakes of iron (from diet alone) below the EAR was lower among supplement users [usesr (17%) vs. non-users (38%)]. These results suggest that among pregnant and lactating women, those who do not use dietary supplements tend to have a lower intake of healthy foods, such as beans and vegetables, as well as a lower intake of dietary fiber and β-carotene, which are abundant in these foods, and non-users are more likely than users to have inadequate intake of micro-nutrient such as vitamin C and iron.     

Home Food Environment Changes and Dietary Intake during an Adolescent Behavioral Weight Loss Intervention Differ by Food Security Status

Behavioral weight loss (BWL) for pediatric obesity includes guidance on improving the home food environment and dietary quality; yet food insecurity presents barriers to making these changes. This study examined if home food environment, dietary quality, energy intake, and body weight changes during adolescent obesity treatment differed by food security status, and if changes in the home food environment were associated with changes in dietary quality and energy intake by food security status. Adolescents (n = 82; 13.7 ± 1.2 years) with obesity participated in a 4-month BWL treatment. Food insecurity, home food environment (Home Food Inventory [HFI]), dietary quality (Healthy Eating Index [HEI]), energy intake, and body mass index (BMI) were assessed at baseline and post-treatment. A reduced obesogenic home food environment and improved dietary quality were observed for food secure (ps < 0.01), but not insecure households (ps > 0.05) (mean difference, HFI: −6.6 ± 6.4 vs. −2.4 ± 7.4; HEI: 5.1 ± 14.4 vs. 2.7 ± 17.7). Energy intake and BMI decreased for adolescents in food secure and insecure households (ps < 0.03) (mean difference; energy intake: −287 ± 417 vs. −309 ± 434 kcal/day; BMI: −1.0 ± 1.4 vs. −0.7 ± 1.4). BWL yielded similar reductions in energy intake and body weight yet did not offer the same benefits for improved dietary quality and the home food environment for adolescents with food insecurity.     

Food intake among children under three years of age in an area with high food insecurity

This study focused on the association between food insecurity and children's dietary intake in a representative sample of children in an area with high food insecurity in Duque de Caxias, Rio de Janeiro State, Brazil. This was a cross-sectional, population-based study with a probabilistic cluster sample of 402 families with children ranging from six to 30 months of age. Food insecurity was assessed based on the Brazilian Food Insecurity Scale (EBIA), and children's dietary intake was evaluated with two 24-hour recalls. Intake levels for food groups, energy, and nutrients were compared according to food insecurity status. Intake of sugar/sweets and fat was high, regardless of food insecurity status, and coffee intake was significantly higher among children with food insecurity. In the energy-adjusted linear regression model, protein intake was inversely associated with the EBIA (p = 0.005). The results suggest that family food insecurity jeopardizes the quality of children's diet, reducing the consumption of protein and increasing the consumption of coffee and high energy density foods.     

Dietary Associations of Household Food Insecurity among Children of Mexican Descent: Results of a Binational Study

Background/objectiveChildren of Mexican descent frequently experience household food insecurity both in the United States and Mexico. However, little is known about the associations of food insecurity with dietary intake. This study aimed to understand the level of perceived food insecurity and its association with dietary intake among children of Mexican descent residing in the United States and Mexico.DesignThis cross-sectional study utilized data from a 2006 binational study of 5-year-old children of Mexican descent living in migrant communities in California and Mexico.MethodsIn California, children were 301 participants from the Center for the Health Assessment of Mothers and Children of Salinas study, a longitudinal birth cohort in a Mexican immigrant community. Mexican children (n=301) were participants in the Proyecto Mariposa study, which was designed to capture a sample of women and their children living in Mexico who closely resembled the California sample, yet who never migrated to the United States. Household food insecurity was measured using the US Department of Agriculture Food Security Scale and dietary intake was assessed with food frequency questionnaires. Analysis of variance was used to examine unadjusted and adjusted differences in total energy, nutrient intake, and consumption of food groups by household food security status.ResultsApproximately 39% of California mothers and 75% of Mexico mothers reported low or very low food security in the past 12 months (P<0.01). Children in the United States experiencing food insecurity consumed more fat, saturated fat, sweets, and fried snacks than children not experiencing food insecurity. In contrast, in Mexico food insecurity was associated with lower intake of total carbohydrates, dairy, and vitamin B-6.ConclusionsPrograms and policies addressing food insecurity in the United States and Mexico may need to take steps to address dietary intake among children in households experiencing food insecurity, possibly through education and programs to increase resources to obtain healthful foods.     

Food Skills and Their Relationship with Food Security and Dietary Diversity Among Asylum Seekers Living in Norway

ObjectiveTo investigate the impact of food skills on food security and dietary diversity among asylum seekers living in Norwegian reception centers.DesignCross-sectional study.SettingEight asylum reception centers.ParticipantsA total of 205 asylum seekers (131 men and 74 women) recruited through convenience sampling.Main Outcome MeasuresFood skills were measured using questions from the Canadian Rapid Response on Food Skills and divided into cooking skills and shopping skills. Food security was measured with the 10-item version of the Radimer/Cornell Scale. The dietary diversity score was based on a 24-h recall.AnalysisBivariate and multivariable logistic regression.ResultsCooking skills were associated with adequate dietary diversity (adjusted odds ratio, 2.12; 95% confidence interval, 1.04–4.31), but not with adult food insecurity (adjusted odds ratio. 0.63; 95% confidence interval, 0.26–1.53). Shopping skills were not associated with either measure of dietary diversity or adult food insecurity. Women had higher cooking skills than men, but there were no gender differences in shopping skills.Conclusions and ImplicationsFood skills had a limited association with food security and dietary diversity. Further research is needed to identify food skills beneficial for asylum seekers and to address the multiple causes of food insecurity.     

Socioeconomic status,food security,and chewing discomfort of Korean elders: results from the Korea National Health and Nutrition Examination Survey

BACKGROUND/OBJECTIVESThe purpose of this study was to investigate the association between socioeconomic status and chewing discomfort and identify the role of food insecurity in the association''s causal pathway in a representative sample of Korean elders.MATERIALS/METHODSWe conducted cross-sectional analyses of the Korea National Health and Nutrition Examination Survey (2013–2015) data for elders aged ≥ 65 years. Socioeconomic status indicators used included household income and education level. Chewing discomfort was assessed according to the self-reported presence of chewing problems. Food security was surveyed using a questionnaire based on the US Household Food Security Survey Module.RESULTSThe odds ratios of chewing discomfort in the 1st and 2nd income quartiles were 1.55 (95% confidence interval [CI], 1.15–2.10) and 1.40 (95% CI, 1.03–1.90), respectively, compared to participants in the highest income quartile. Participants with the lowest education level were 1.89 (95% CI, 1.30–2.75) times more likely to have chewing discomfort than those without chewing discomfort. After including food security in the final model, the logistic coefficients were attenuated in the income and education quartiles.CONCLUSIONSLow socioeconomic status was associated with chewing discomfort. In addition, the results confirm that food insecurity can mediate the association between socioeconomic inequalities and chewing discomfort among the elderly.     

Food Security Status of Native Hawaiians and Pacific Islanders in the US: Analysis of a National Survey

ObjectiveTo document food insecurity prevalence among a nationally representative sample of Native Hawaiian and Pacific Islander (NHPI) adults and compare differences in food security status across races/ethnicities in the US.MethodsUsing 2014 National Health Interview Survey and 2014 NHPI–National Health Interview Survey data, food insecurity among the NHPI population is described and food security status across racial/ethnic groups is compared using Rao-Scott chi-square and multinomial logistic regression.ResultsFood insecurity prevalence was 20.5% among NHPI adults, and NHPI had significantly higher odds of experiencing low and very low food security than white individuals. Food insecurity among Hispanic individuals, black people, and other races/ethnicities was also significantly higher than that among white people. Significant variation in food security status was observed by race/ethnicity (P < .001).Conclusions and ImplicationsThis study provides documentation of food insecurity prevalence among NHPI adults and will inform chronic disease and nutrition research and programs conducted with NHPI communities in the US.