Home gardening in urban poor communities of the Philippines

The deficiencies of micronutrients, in particular iron and vitamin A, are common in the Philippines, but their control measures through supplementation and fortification have shown several weaknesses. The present study examines the outcomes of a community-based approach including promotion of home gardening and a diversified dietary practice. A total of 152 mothers in two poor urban communities in Davao City, the Philippines were interviewed with a structured questionnaire. Participants were also asked to keep a brief 7-day self-administered household food record. Focus group discussions were conducted to obtain in-depth information on their attitudes toward home gardening and vegetable consumption. Home garden produce contributed to the diversification of carbohydrate consumed among participants. However, home garden produce reduced the consumption of protein-rich food. There was therefore no discernible improvement in the diets of participants from the consumption of home garden produce. In communities where there was no greengrocer, respondents shared the produce from home gardens. The community-based diet improvement program facilitated home gardening practices, which influenced the dietary practices of the urban poor. The monitoring of food consumption together with community-based programs needs to be expanded in urban poor communities. Our focus group discussion revealed that there was a cognition linking home gardening and vegetable consumption to poverty among some of the participants. More study is necessary on this finding.     

Home gardening in urban poor communities of the Philippines

The deficiencies of micronutrients, in particular iron and vitamin A, are common in the Philippines, but their control measures through supplementation and fortification have shown several weaknesses. The present study examines the outcomes of a community-based approach including promotion of home gardening and a diversified dietary practice. A total of 152 mothers in two poor urban communities in Davao City, the Philippines were interviewed with a structured questionnaire. Participants were also asked to keep a brief 7-day self-administered household food record. Focus group discussions were conducted to obtain in-depth information on their attitudes toward home gardening and vegetable consumption. Home garden produce contributed to the diversification of carbohydrate consumed among participants. However, home garden produce reduced the consumption of protein-rich food. There was therefore no discernible improvement in the diets of participants from the consumption of home garden produce. In communities where there was no greengrocer, respondents shared the produce from home gardens. The community-based diet improvement program facilitated home gardening practices, which influenced the dietary practices of the urban poor. The monitoring of food consumption together with community-based programs needs to be expanded in urban poor communities. Our focus group discussion revealed that there was a cognition linking home gardening and vegetable consumption to poverty among some of the participants. More study is necessary on this finding.     

Academy of Nutrition and Dietetics Nutrition Research Network: A Home Garden Intervention Improves Child Length-for-Age Z-Score and Household-Level Crop Count and Nutritional Functional Diversity in Rural Guatemala

Home gardens may help address childhood malnutrition in low- and middle-income countries. In this quasi-experimental pilot study, the Academy of Nutrition and Dietetics, in collaboration with Maya Health Alliance, evaluated the feasibility of augmenting a standard-of-care nutrition-specific package for Maya children with length-for-age z score ≤?2 (stunting) in rural Guatemala with a nutrition-sensitive home garden intervention. Two agrarian municipalities in Guatemala were included. Families of 70 children with stunting from 1 municipality received the standard-of-care package (food supplementation, multiple micronutrient powders, monthly nutrition home visits, group nutrition classes). Families of 70 children with stunting from another municipality received the standard-of-care package plus a home garden intervention (garden materials, monthly agricultural home visits, agriculture classes). Maternal and child dietary diversity, household food insecurity, child growth, and agricultural indicators were collected at baseline and 6 months later and were analyzed using mixed linear and logistic regression models. Compared with the standard-of-care group, the garden intervention group had improved child (odds ratio [OR] 3.66, 95% CI 0.89-15.10, P = 0.07) and maternal dietary diversity (OR 2.31, 95% CI 0.80-6.65, P = 0.12) and decreased food insecurity (OR 0.38, 95% CI 0.11-1.35, P = 0.14); however, these effects were not statistically significant. Participation in gardens predicted a higher length-for-age z-score (change difference [CD] 0.22 SD, 95% CI 0.05-0.38, P = 0.009), greater crop species count (CD 2.97 crops, 95% CI 1.79-4.16, P < 0.001), and greater nutritional functional diversity (CD 0.04 points, 95% CI 0.01-0.07, P = 0.006) than standard-of-care alone. Home garden interventions are feasible in rural Guatemala and may have potential benefits for child growth when added to other nutrition-specific interventions.     

The 2008 food price crisis negatively affected household food security and dietary diversity in urban burkina faso

Although the 2008 food price crisis presumably plunged millions of households into poverty and food insecurity, the real impact of the crisis has rarely been documented using field data. Our objective was to assess the consequences of this crisis for household food insecurity and dietary diversity in urban Burkina Faso. Two cross-sectional surveys were conducted among randomly selected households in Ouagadougou in July 2007 (n = 3017) and July 2008 (n = 3002). At each round, food insecurity assessed by the Household Food Insecurity Access Scale (HFIAS), the Dietary Diversity Score of an index-member of the household (IDDS = number of food groups consumed in the last 24 h), and food expenditure were collected. Food prices of the 17 most frequently consumed food items were recorded throughout the study area. Food prices at local markets increased considerably between 2007 and 2008, especially those of fish (113%), cereals (53%), and vegetable oil (44%), increasing the household monthly food expenditure by 18%. Thirty-three percent of households were food secure in 2007 and 22% in 2008 (P = 0.02). Individuals consumed fewer fruits and vegetables, dairy products, and meat/poultry in 2008 than in 2007 (mean IDDS = 5.7 ± 1.7 food groups in 2007 vs. 5.2 ± 1.5 in 2008; P < 0.0001). Differences in IDDS and HFIAS between the 2 y were even more marked after adjustment for confounding factors and food expenditure. Food security and dietary diversity significantly decreased between 2007 and 2008, whereas food prices increased. Households increased their food expenditure, but this was not sufficient to compensate the effects of the crisis.     

Dietary Sodium Intake and Its Relation to Human Health: A Summary of the Evidence

Objectives: Relating food diversity, quality, and intake is one of the key aspects in understanding household food security. This paper aimed at marying food intake and quality, both being measurement for food security.

Methods: A household food consumption survey (n = 200) exploring food diversity, quality of foods, and their relation to food intake in Embo, a poor farming community in rural KwaZulu-Natal was carried out in November 2004 (period of insufficiency) and repeated in March 2005 (period of plenty). Household food intake strata were developed using matrices obtained from the Household Food Intake Index and nutritional adequacy ratios. Food quality was measured using food count and later using 5 food groups, namely, starches, vegetables and fruits,animal sourced foods, fats, and legumes.

Results: Single food count showed dietary diversity to be significantly different across households with different food intake during the period of plenty (P ≤ 0.000). During the period of plenty, vegetable and fruits contributed significantly different proportions of energy (P ≤ 0.000), protein (P ≤ 0.006), iron (P ≤ 0.020), and vitamin E (P ≤ 0.006) to household food intake strata. Intake of vitamin A was more elastic as its intake variation from legumes, fats, and animal sourced foods was (P ≤ 0.000), from starches (P ≤ 0.008) and from vegetable and fruits (P ≤ 0.064) during the second round. Starches are the most important food group to the community, whereas fats and animal sourced food groups are less important.

Conclusions: The current study has been able to include food quality in food security studies. Seasonality accounts for variation in food quality. The South African food-based dietary guidelines are relevant to the Embo community.     

LA Sprouts: a gardening, nutrition, and cooking intervention for Latino youth improves diet and reduces obesity

Evidence demonstrates that a gardening and nutrition intervention improves dietary intake in children, although no study has evaluated the effect of this type of intervention on obesity measures. The objective of this pilot study was to develop and test the effects of a 12-week, after-school gardening, nutrition, and cooking program (called LA Sprouts) on dietary intake and obesity risk in Latino fourth- and fifth-grade students in Los Angeles, CA. One hundred four primarily Latino children (mean age 9.8±0.7 years), 52% boys and 59% overweight, completed the program (n=70 controls, n=34 LA Sprouts participants). Weight, height, body mass index, waist circumference, body fat (via bioelectrical impendence), blood pressure, and dietary intake (via food frequency screener) were obtained at baseline and postintervention. LA Sprouts participants received weekly 90-minute, culturally tailored, interactive classes for 12 consecutive weeks during spring 2010 at a nearby community garden, whereas control participants received an abbreviated delayed intervention. Compared to subjects in the control group, LA Sprouts participants had increased dietary fiber intake (+22% vs −12%; P=0.04) and decreased diastolic blood pressure (−5% vs −3%; P=0.04). For the overweight subsample, LA Sprouts participants had a significant change in dietary fiber intake (0% vs −29%; P=0.01), reduction in body mass index (−1% vs +1%; P=0.04) and less weight gain (+1% vs +4%; P=0.03) compared to those in the control group. We conclude that a gardening, nutrition, and cooking intervention is a promising approach to improve dietary intake and attenuate weight gain in Latino children, particularly in those who are overweight.     

Severity of household food insecurity and lifetime racial discrimination among African-American households in South Carolina

Objectives: In 2014, 30% of African-American households with children had low or very low food security, a rate double that of white households with children. A household has low food security if its members experience food shortages and reductions in food quality attributable to a lack of household resources or access and very low food security if its members also experience reductions in food intake and disrupted eating patterns. Households that are either low or very low food secure are known collectively as food insecure. We examined the association between the severity of household food insecurity and reports of lifetime racial discrimination among a sample of food-insecure African-American households in South Carolina.

Design: Data were collected from 154 African-American respondents. Food insecurity was measured using the US Department of Agriculture’s Household Food Security Survey Module. Lifetime racial discrimination was measured using the Perceived Ethnic Discrimination Questionnaire-Community Version (PEDQ-CV). We used logistic regression to test the association between severity of food insecurity (low vs. very low food secure), PEDQ-CV score and PEDQ-CV subscales. All models were adjusted for demographic and socioeconomic variables.

Results: A one-unit increase in the frequency of lifetime racial discrimination was associated with a 5% increase in the odds of being very low food secure (odds ratio (OR) 1.05, P?P?P?P?P?>?.05).

Conclusions: Severity of household food insecurity is associated with lifetime racial discrimination among African-American households in South Carolina.     

Home gardening and food preservation practices of the elderly in rural Kentucky

Previous research on the nutritional vulnerability of the elderly has failed to examine the unique potential for dietary enhancement provided by gardening and food preservation among the rural elderly. The goal of this paper is to describe contemporary home gardening and food preservation practices in persons 55 years and older in rural Kentucky. Data come from a year of qualitative research and two subsequent surveys designed to record seasonal variation in diet and nutritional strategies of a sample of 639 respondents. Fifty‐six percent of the elders had home gardens; they were in better functional status and less likely to live alone than nongardeners. A core garden of 7 items most commonly raised was identified from a total of 22 items reported. Most elders preserved home produce; preservation techniques specific to particular foods are identified. Patterns of foods grown and favored preservation techniques are analyzed in relation to historical traditions, traditional beliefs, and food preferences in the region.     

Diet Quality and Fruit,Vegetable, and Sugar-Sweetened Beverage Consumption by Household Food Insecurity among 8- to 12-Year-Old Children during Summer Months

BackgroundSchool-delivered nutrition assistance programs have improved dietary intake for children from food-insecure households during the school year. However, little is known about their diet quality and eating patterns during summer months.ObjectiveSchool-aged children’s summer month weekday and weekend day diet quality and eating patterns were assessed by household food insecurity.DesignSecondary analysis of cross-sectional data was employed.Participants/settingDuring the summers of 2011 through 2017, baseline data were collected from parent–child dyads participating in one of two community-based obesity prevention trials in metropolitan Minnesota (N=218). The mean age of children was 10 years; 50% were girls, 49% were nonwhite, and 25% were from food-insecure households.Main outcome measuresChildren from food-secure and food-insecure households were identified by using the short form of the US Household Food Security Survey. Healthy Eating Index 2015 and eating patterns—including energy intake and consumption of whole fruits, vegetables, 100% fruit/vegetable juice, and sugar-sweetened beverages—were estimated by means of 24-hour dietary recall interviews conducted on weekdays and weekend days.Statistical analysis performedGeneral linear modeling was used to examine diet quality and eating patterns by food insecurity, controlling for child age, child body mass index z score, and parent education.ResultsChildren from food-insecure and food-secure households had Healthy Eating Index 2015 scores less than 50. Children from food-insecure households reported less energy intake, fewer cups of whole fruit, and more sugar-sweetened beverage consumption for every 1,000 kcal consumed on a weekend day when compared with their counterparts from food-secure households (P<0.05). Similar results were not seen for weekday eating patterns.ConclusionsWhole fruit and sugar-sweetened beverage consumption varied by food insecurity on weekend days during summer months. Because children tend to gain weight during summer months, efforts to increase weekend access to whole fruits and promote water consumption may contribute to weight gain prevention and healthy development, especially for children from food-insecure households.     

Impact of a Community Gardening Project on Vegetable Intake, Food Security and Family Relationships: A Community-based Participatory Research Study

This community-based participatory research project used popular education techniques to support and educate Hispanic farmworker families in planting and maintaining organic gardens. Measures included a pre- post gardening survey, key informant interviews and observations made at community-based gardening meetings to assess food security, safety and family relationships. Thirty-eight families enrolled in the study during the pre-garden time period, and four more families enrolled in the study during the post-garden period, for a total of 42 families enrolled in the 2009 gardening season. Of the families enrolled during the pre-gardening time period there were 163 household members. The mean age of the interviewee was 44.0, ranging from 21 to 78 years of age. The median number of occupants in a household was 4.0 (range: 2-8), Frequency of adult vegetable intake of "Several time a day" increased from 18.2 to 84.8%, (P < 0.001) and frequency of children's vegetable intake of "Several time a day" increased from 24.0 to 64.0%, (P = 0.003). Before the gardening season, the sum of the frequencies of "Sometimes" and "Frequently" worrying in the past month that food would run out before money was available to buy more was 31.2% and the sum of these frequencies dropped to 3.1% during the post garden period, (P = 0.006). The frequency of skipping meals due to lack of money was not statistically significantly different before and after the gardening season for either adults or children. Analysis of text responses and key informant interviews revealed that physical and mental health benefits were reported as well as economic and family health benefits from the gardening study, primarily because the families often worked in their gardens together. A community gardening program can reduce food insecurity, improve dietary intake and strengthen family relationships.     

Household food security among migrant and seasonal latino farmworkers in North Carolina

OBJECTIVE: Food insecurity is defined as lack of access at all times, due to economic barriers, to enough food for an active and healthy lifestyle. The objective of this study was threefold: to characterize levels of food security, food insecurity, and hunger among migrant and seasonal Latino farmworkers; to assess predictors of food insecurity for this group; and to describe the strategies farmworkers use to cope with food insecurity. METHODS: Adults from 102 farmworker households in North Carolina responded to a survey that used a Spanish-language adaptation of the U.S. Household Food Security Survey Module and questions about sociodemographic characteristics and food behaviors. Twenty-five farmworkers participated in in-depth interviews in which they described their households' food security situation and coping strategies. RESULTS: Forty-eight of the 102 sample households (47.1%) were classified as food insecure, including 10 (9.8%) with moderate hunger and five (4.9%) with severe hunger. Households with children had a significantly higher prevalence of food insecurity than those without children (56.4% vs. 36.2%). Households with children accessed food programs such as the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) that were unavailable to those without children, while those without children were more likely to access food pantries and to consume wild game or fish. Coping strategies included borrowing money, reducing food variety, and adults consuming less food to protect children from hunger. Food insecurity was more than four times as prevalent among farmworker households as among the general U.S. population. CONCLUSION: Policy changes to increase economic resources and access to federal programs are needed to decrease this food insecurity.     

Socio-demographic influences on food purchasing among Canadian households

OBJECTIVE: To characterize the relationships between selected socio-demographic factors and food selection among Canadian households. DESIGN: A secondary analysis of data from the 1996 Family Food Expenditure survey was conducted (n=10,924). Household food purchases were classified into one of the five food groups from Canada's Food Guide to Healthy Eating. Parametric and non-parametric modelling techniques were employed to analyse the effects of household size, composition, income and education on the proportion of income spent on each food group and the quantity purchased from each food group. RESULTS: Household size, composition, income and education together explained 21-29% of the variation in food purchasing. Households with older adults spent a greater share of their income on vegetables and fruit (P<0.0001), whereas households with children purchased greater quantities of milk products (P<0.0001). Higher income was associated with purchasing more of all food groups (P<0.0001), but the associations were nonlinear, with the strongest effects at lower income levels. Households where the reference person had a university degree purchased significantly more vegetables and fruit, and less meat and alternatives and 'other' foods (P<0.0001), relative to households with the lowest education level. CONCLUSIONS: Household socio-demographic characteristics have a strong influence on food purchasing, with the purchase of vegetables and fruit being particularly sensitive. Results reinforce concerns about constraints on food purchasing among lower income households. Furthermore, the differential effects of income and education on food choice need to be considered in the design of public health interventions aimed at altering dietary behaviour.     

“We need our own food,to grow our own veggies…” Remote Aboriginal food gardens in the Top End of Australia's Northern Territory

Objective: Remote Aboriginal community gardens (gardens) frequently operate below their full potential. A set of gardening sustainability principles may improve their planning, operation and long‐term sustainability. This paper aims to document the principles of sustainability of non‐profit remote Aboriginal community gardens in the Top End of the Northern Territory. Methods: Throughout 2011, gardens in the Top End of the Northern Territory were visited. Interviews and observational data were used to explore the principles of garden sustainability with participants. Subsequent iterative thematic analysis informed development of a set of gardening sustainability principles. Results: Principles of sustainability included effective garden planning; community autonomy, consultation and engagement; growing community vetted crops; employing long‐term, effective, culturally sensitive managers; long‐term, transparent funding organisations and cycles; garden integration into existing food supply chains; culturally appropriate employment arrangements; and physical aspects of successful gardening. Conclusions: This work uniquely consults gardeners, managers and Aboriginal and non‐Aboriginal people of both genders in the largest reported study of its type, resulting in new and expanded findings, particularly including new social factors for gardening success. Implications: Expanding the understanding of what makes gardens work to include the important social factors identified here may have merit.     

A Garden Pilot Project Enhances Fruit and Vegetable Consumption among Children

Fruit and vegetable intake among children is inadequate. Garden-based nutrition education programs may offer a strategy for increasing fruit and vegetable intake in children. A 12-week pilot intervention was designed to promote fruit and vegetable intake among 4th to 6th grade children (n=93) attending a YMCA summer camp. Children participated in garden-based activities twice per week. Weekly educational activities included fruit and vegetable taste tests, preparation of fruit and vegetable snacks, and family newsletters sent home to parents. The pilot intervention was evaluated using a pre and post survey to determine participant satisfaction and the short-term impacts of the program. The process evaluation focused on program satisfaction, whereas the short-term impact evaluation assessed fruit and vegetable exposure, preference, self-efficacy, asking behavior, and availability of fruits and vegetables in the home. Data from the impact evaluation were compared from baseline to follow-up using McNemar's test (dichotomous variables) and Wilcoxon signed rank test (scales/continuous variables). Children reported high levels of enjoyment in the intervention activities. Most children (97.8%) enjoyed taste-testing fruits and vegetables. Children also liked preparing fruit and vegetable snacks (93.4%), working in their garden (95.6%), and learning about fruits and vegetables (91.3%). Impact data suggest that the intervention led to an increase in the number of fruits and vegetables ever eaten (P<0.001), vegetable preferences (P<0.001), and fruit and vegetable asking behavior at home (P<0.002). Garden-based nutrition education programs can increase fruit and vegetable exposure and improve predictors of fruit and vegetable intake through experiential learning activities. Participation in the “seed to table” experience of eating may help promote healthful eating behaviors among youth. Food and nutrition professionals should consider garden-based nutrition education programs that connect children with healthful foods through fun, hands-on activities.     

Food Gardeners’ Productivity in Laramie,Wyoming: More Than a Hobby

Objectives. We quantified the productivity of food gardens in Laramie, Wyoming, over 3 growing seasons.Methods. From 2012 to 2014, 33 participating gardening households weighed and recorded each harvest. Academic partners measured plot sizes and converted reported harvest weights to volume in cups.Results. The yield of the average 253-square-foot plot was enough to supply an adult with the daily US Department of Agriculture–recommended amount of vegetables for 9 months.Conclusions. Gardeners produced nutritionally meaningful quantities of food; thus, food gardening offers promise as an effective public health intervention for improving food security and nutritional health.In the United States, major public health nutrition problems include low vegetable consumption, high food insecurity and obesity rates, and lack of access to a local grocery store.1–3 Growing vegetables in home and community gardens offers a promising strategy for improving these issues. A large body of observational research suggests that home and community food gardening yields a wide range of health benefits, including improved fruit and vegetable consumption, activity levels, and mental health.4–7However, only a handful of studies have documented how much food gardens yield (Table A, available as a supplement to the online version of this article at http://www.ajph.org), and none have quantified these harvests in terms of vegetable servings provided. We have added to this emerging literature by (1) quantifying harvest results in a climate zone that is more challenging for growing than are the locations of previous studies, (2) quantifying results over 3 growing seasons, (3) calculating harvest values in nutritional terms as servings of vegetables yielded, and (4) quantifying how gardeners used their harvests, whether eaten immediately, stored, or shared.     

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.     

Marginal,Low, and Very-Low Food Security among Children Are Associated with Intake of Select Dietary Factors during Summer

BackgroundSchool meals are associated with improved food security status and dietary intake. Children receiving free and reduced-price school meals lose access to these meals during the summer. The association between food security status and dietary intake in these children during summer is unclear.ObjectiveTo examine the association between food security status (high, marginal, low, and very-low food security) among children and intake of select dietary factors during summer in children certified for free and reduced-price school meals by age group (3 to 4 years, 5 to 8 years, 9 to 12 years, and 13 to 17 years).DesignCross-sectional analysis.Participants/settingSecondary data from 11,873 children aged 3 to 17 years in the control group of the US Department of Agriculture Summer Electronic Benefit Transfer for Children Demonstration Project.Main outcome measuresConsumption of total fruits and vegetables; fruits and vegetables, excluding fried potatoes; whole grains; added sugars; added sugars, excluding cereals; added sugars from sugar-sweetened beverages; and dairy products assessed using questions from the 2009-2010 National Health and Nutrition Examination Survey Multifactor Diet Screener.Statistical analysisMultiple linear regression.ResultsFor the majority of age groups, marginal food security, low food security, and very-low food security were associated with lower fruit and vegetable consumption and low food security and very-low food security were associated with lower dairy consumption, with children from households with very-low food security having the lowest consumption. Children from households with very-low food security consumed 0.73 (95% CI –0.93 to –0.53) to 0.99 (95% CI –1.59 to –0.39) cup equivalents less per day of fruits and vegetables and 0.49 (95% CI –0.65 to –0.34) to 0.68 (95% CI –1.07 to –0.29) cup equivalents less per day of dairy compared with children from households experiencing high food security.ConclusionsLower food security was associated with reduced consumption of fruits and vegetables and dairy products during summer in children from low-income households.     

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.     

Household Food Insecurity and Home Food Availability in Relation to Youth Diet,Body Mass Index,and Adiposity

BackgroundFood security status is related to food types available in the home, which may shape youth dietary patterns, with implications for obesity.ObjectiveInvestigate whether household food insecurity and home food availability (HFA) are associated with youth fruit and vegetable (F/V) consumption and anthropometric outcomes.DesignCross-sectional study. Youth and parents completed questionnaires during in-home visits (2013-2014). Research staff obtained anthropometric measures.Participants/settingMedical record data for 10- to 15-year-old Pennsylvania youths were used to identify 434 parent-youth dyads, with 408 evaluated after excluding missing data.Main outcome measuresParent-reported household food security was assessed with the six-item US Department of Agriculture Food Security Scale (dichotomized as high vs low). Healthy and obesogenic HFA scales assessed parent report of how frequently particular foods were present in the home. Youth self-reported daily average F/V consumption. Anthropometric outcomes included age- and sex-standardized z scores for body mass index (BMIz), waist circumference (WCz), and percent body fat (PBFz).Statistical analysesAssociations were evaluated with multivariable linear regression adjusted for youth age, sex, and race or ethnicity, and parent age and income.ResultsCompared with food secure counterparts, youth from food insecure households had higher mean (beta [standard error]) BMIz (.30 [.15]), WCz (.27 [.12]), and PBFz (.43 [.16]). Food insecure households had lower mean healthy HFA scores (?1.23 [.54]); there was no evidence obesogenic HFA differed between food secure and insecure households. Youth from lower healthy HFA or higher obesogenic HFA households reported fewer mean daily F/V servings (healthy HFA: .08 [.02]; obesogenic HFA: ?.06 [.02]). Food security status was not associated with F/V consumption, nor was there evidence HFA modified associations between food insecurity and anthropometric outcomes.ConclusionsDespite an observed association between healthy HFA and youth F/V consumption, this study did not provide evidence that HFA explained associations between food insecurity and youth anthropometric outcomes.