Varying Levels of Food Insecurity Associated with Clinically Relevant Depressive Symptoms in U.S. Adults Aged 60 Years and Over: Results from the 2005–2014 National Health and Nutrition Survey

Abstract

Food insecurity refers to restricted or uncertain access to and ineffective utilization of nutritious and safe foods. Although food insecurity is linked to poorer physical health consequences among older adults, national estimates are not well known on food insecurity and depression. Using the 2005–2014 National Health and Nutrition Examination Survey, this study examines the associations between varying food insecurity levels and clinically relevant depressive symptoms (defined by PHQ-9?≥?10) among adults ≥60?years old (n?=?7969). Rates of clinically relevant depressive symptoms in marginal, low, and very low food security were 12.3, 16.3, and 25.2%, respectively. Marginal, low, and very low food security were significantly associated with clinically relevant depressive symptoms: odds ratio (OR)?=?1.12 (95% confidence intervals [CI] 1.07–1.18), OR?=?1.07 (95% CI 1.03–1.12), and OR?=?1.24 (95% CI 1.16–1.32), respectively. Given the intersection of food insecurity and depression, geriatric health professionals should work to improve health and nutrition programs for older adults at risk for or experiencing both public health concerns.     

Does Depressive Affect Mediate the Relationship between Self-Care Capacity and Nutritional Status Among Rural Older Adults? : A Structural Equation Modeling Approach

This study examined the relationships of self-care capacity and depressive affect on nutritional status and whether depressive affect mediated the relationship of self-care capacity on nutritional status. A convenience sample of 171 rural community-dwelling older adults, 65 years and above, participated. Structural equation modeling (SEM) was conducted to test a mediation model. The hypothesized SEM model was supported with adequate fit (χ² (1)?=?1.87, p?=?0.17; CFI?=?0.94; RMSEA?=?0.07; SRMR?=?0.03). SEM analysis revealed a significant positive direct effect of self-care capacity on nutritional status (γ?=?0.14, p?=?0.042). Significant negative direct effects were observed for self-care capacity on depressive affect (γ?=??0.15, p?=?0.027) and for depressive affect on nutritional status (β?=??0.27, p?相似文献   

Food Insecurity and Functional Disability Among Older Adults in Ghana: The Role of Sex and Physical Activity

ObjectivesWe examined the associations between food insecurity and functional disability among older adults in Ghana and, the roles of sex and physical activity on the relationship.DesignA cross-sectional study design was employed.Setting and participantsA total of 4446 older adults (50+ years of age) from the Study on Global Aging and Adult Health Ghana Wave 2, a countrywide study, was completed in 2015.MethodsLogistic regression models were used to examine the associations between measures of food insecurity and functional disability using data from Study on Global Aging and Adult Health Ghana Wave 2. Functional disability was assessed using World Health Organization Disability Assessment Schedule 2.0 composed of 12 items in 6 domains of cognition, mobility, self-care, getting along, life activities, and participation in society. Food insecurity was assessed from 12-month food sufficiency and experience of hunger over the last 12 months.ResultsApproximately 11% were identified as having functional disability. The prevalence of food insecurity was 23.8% for insufficient food intake and 18.3% for hunger. Adjusting for all variables, older adults who reported consuming insufficient food (OR 2.27; 95% CI 1.57, 3.28), and those who experienced hunger (OR 2.35; 95% CI 1.59, 3.46) had higher odds of functional disability, compared with those not reporting these issues. Sex differences modified the association between hunger and functional disability. Physical activity served as a protective factor (OR 0.60; 95% CI 0.38, 0.95) on the association implying that older adults who engaged in physical activity were 40% less likely to experience food insecurity-induced functional disability.Conclusions and ImplicationsFood insecurity is associated with functional disability among older adults. Results highlight the usefulness of tackling the social determinants of health and promoting financial/social security in older age in a changing Ghanaian society.     

Indicators of material hardship and depressive symptoms among homebound older adults living in North Carolina

This study used the concept of material hardship to understand how unmet needs related to food, housing, and health influence depressive symptoms among homebound older adults (N = 345) in North Carolina. Using data from the Nutrition and Function Study, 37% reported high levels of depressive symptoms and 17.4% indicated not receiving needed health care. Approximately 10% of respondents were food insecure; 30.7% were at risk for food insecurity; and 39.7% reported having to choose between either food and medication or food and paying bills. Adjusted logistic regression model revealed that food insecurity status (OR = 4.9) and age 60-74 y (OR = 2.4) were significantly associated with a greater number of depressive symptoms. Other indicators of material hardship, such as having a major financial difficulty, unmet health need, and inadequate housing, were not significant. By far, food insecurity was the most salient influence on depressive symptoms. These findings have important implications for service providers, researchers, and policymakers.     

Association of Food Insecurity and Food Addiction Symptoms: A Secondary Analysis of Two Samples of Low-Income Female Adults

BackgroundHousehold food insecurity persists in the United States and has important implications for health and well-being. Food insecurity in female-identified caregivers is particularly concerning, given its association with their mental health and adverse health outcomes for their children. Food insecurity is associated with disordered eating but, to our knowledge, no prior studies have examined an association between food insecurity and food addiction.ObjectiveOur aim was to examine whether food insecurity is associated with higher food addiction symptom endorsement in low-income female adults.DesignSecondary analysis of baseline data from a quasi-experimental study of a mindfulness-based intervention on gestational weight gain among low-income pregnant individuals and an observational study of low-income families.Participants/settingParticipants in study 1 (n = 208) were English-speaking, low-income pregnant individuals with overweight or obesity, recruited in California from 2011 to 2013. Participants in study 2 (n = 181) were English-speaking, low-income female caregivers for children aged 8 through 10 years, recruited in Michigan from 2018 to 2019. Both studies recruited participants from community health clinics, social service agencies, and online advertisements.Main outcome measuresThe primary outcome measure was food addiction symptoms, assessed by the Yale Food Addiction Scale.Statistical analysisMultivariate Poisson regression was used to examine the association between household food insecurity and food addiction symptoms in each sample, adjusted for sociodemographic characteristics.ResultsIn study 1, pregnant individuals in food-insecure households reported 21% higher food addiction symptoms than pregnant individuals in food-secure households (incidence rate ratio 1.21; 95% CI 1.00 to 1.47; P = .047). In study 2, caregivers in food-insecure households had 56% higher food addiction symptoms than caregivers in food-secure households (incidence rate ratio 1.56; 95% CI 1.01 to 2.40; P = .045).ConclusionsThese findings provide preliminary support for a relationship between household food insecurity and food addiction. Future research should examine potential mechanisms and whether interventions to reduce food insecurity lower risk of food addiction.     

The Relationship between Food Security Status and Sleep Disturbance among Adults: A Cross-Sectional Study in an Indonesian Population

Background: The relationship between food insecurity and the experience of sleep disturbance has received little attention among researchers, although food insecurity is associated with poor physical and mental health globally. This study aimed to investigate the relationship between food security status and sleep disturbance among adults 20–64 years old. Methods: The study’s population-based sample included 20,212 Indonesian adults who participated in the fifth wave of the Indonesia Family Life Survey (IFLS5) in 2014. Dietary intake data, gathered using a food frequency questionnaire (FFQ), were used to assess the food security status. Sleep disturbance was assessed using the 10-item Patient-Reported Outcomes Measurement Information System (PROMIS) questionnaire. We used multiple linear and logistic regression models to test the study hypothesis. Results: A higher likelihood of experiencing sleep disturbance was recorded in people aged older than 56 years (OR = 1.78, 95% CI: 1.17–2.72, p = 0.007), people with depressive symptoms (OR = 3.57, 95% CI: 2.77–4.61, p < 0.001), and food-insecure people (OR = 1.32, 95% CI: 1.02–1.70, p = 0.036). A lower likelihood of experiencing sleep disturbance was recorded in people with low educational attainment (OR = 0.41, 95% CI: 0.30–0.57, p < 0.001). Sleep disturbance was dependent on the food consumption groups and food security status among men (p = 0.004). Conclusions: Sleep disturbance may be affected by the food-insecure status of adults, and later, may lead to serious health outcomes.     

Examining the bidirectional relationship between food insecurity and healthcare spending

ObjectiveTo improve food insecurity interventions, we sought to better understand the hypothesized bidirectional relationship between food insecurity and health care expenditures.Data SourceNationally representative sample of the civilian noninstitutionalized population of the United States (2016‐2017 Medical Expenditure Panel Survey [MEPS]).Study DesignIn a retrospective longitudinal cohort, we conducted two sets of analyses: (a) two‐part models to examine the association between food insecurity in 2016 and health care expenditures in 2017; and (b) logistic regression models to examine the association between health care expenditures in 2016 and food insecurity in 2017. We adjusted for demographic and socioeconomic variables as well as 2016 health care expenditures and food insecurity.Data CollectionHealth care expenditures, food insecurity, and medical condition data from 10 886 adults who were included in 2016‐2017 MEPS.Principal FindingsFood insecurity in 2016, compared with being food secure, was associated with both a higher odds of having any health care expenditures in 2017 (OR 1.29, 95% CI: 1.04 to 1.60) and greater total expenditures ($1738.88 greater, 95% CI: $354.10 to $3123.57), which represents approximately 25% greater expenditures. Greater 2016 health care expenditures were associated with slightly higher odds of being food insecure in 2017 (OR 1.007 per $1000 in expenditures, 95% CI: 1.002 to 1.012, P =0.01). Exploratory analyses suggested that poor health status may underlie the relationship between food insecurity and health care expenditures.ConclusionsA bidirectional relationship exists between food insecurity and health care expenditures, but the strength of either direction appears unequal. Higher health care expenditures are associated with a slightly greater risk of being food insecure (adjusted for baseline food insecurity status) but being food insecure is associated with substantially greater subsequent health care expenditures (adjusted for baseline health care expenditures). Interventions to address food insecurity and poor health may be helpful to break this cycle.     

Food Insecurity and Perceived Diet Quality Among Low-Income Older Americans with Functional Limitations

Objective

To evaluate how functional limitations are associated with food insecurity and perceived diet quality in low-income older Americans.

Role of Family Stressors on Rural Low-Income Children’s Behaviors

Background

Exposure to multiple stressors and lack of access to resources place rural children at high risk for adverse consequences. Family Stress Model guided this study to examine relations between two stressors- food insecurity and maternal depressive symptoms, and behavior problems among younger and older rural children.

Objective

To test associations between food insecurity, maternal depressive symptoms, and behavior problems among younger and older rural low-income children.

Methods

Cross-sectional data from 370 low-income rural families across 13 states was analyzed using structural equation modeling and multiple group analyses. Mothers’ education level, household income, marital/partner status, and participation in SNAP served as covariates.

Results

Among younger children, maternal depressive symptoms partially mediated the relation between food insecurity and child externalizing behaviors, while among older children, maternal depressive symptoms completely mediated the relation between food insecurity and child internalizing and externalizing behaviors.

Conclusions

Stress manifested directly from, or indirectly through, maternal depressive symptoms and from food insecurity was related to behavior problems among younger and older rural children; however, the relations varied by age of children. Programs and policies that prevent or lessen both food insecurity and maternal depression may help to lessen problem behaviors among on rural children. Longitudinal studies are needed to rigorously examine causation and directionality among food insecurity, maternal depression and rural child behavior problems, while accounting for influences of child, caregiver and family characteristics.

     

Relationship Between Food Insecurity and Functional Limitations in Older Adults from 2005–2014 NHANES

Abstract

Background: Food insecurity refers to the physical, social, and economic inability to access and secure sufficient, safe and nutritious food. Food insecurity has been found to be associated with poor health status, obesity, and chronic disease. To date, a relationship between food insecurity and functional limitations has not been described in of older adults.

Methods: We examined 9309 adults ≥60 years old from the 2005–2014 National Health and Nutrition Examination Surveys (NHANES). Food security was categorized as full, marginal, low, and very low. Functional limitations were assessed as having difficulty in physical, basic or instrumental activities of daily living.

Results: Of adults ≥60 years old (mean age: 70.5?±?0.08, 51% female), the prevalence of full, marginal, low, or very low food insecurity was 7572 (81%), 717 (7%), 667 (8%), and 353 (4%), respectively. The prevalence of any functional limitations was 5895 (66.3%). The adjusted odds (OR [95%CI]) of having any functional limitation in marginal, low, and very low food security levels compared to full food security are: 1.08 [1.02–1.13], 1.16 [1.10–1.22], 1.14 [1.07–1.21], respectively. The association between levels of food insecurity and functional limitation is modified by race/ethnicity.

Conclusions: Functional limitation is significantly associated with increasing food insecurity in older adults.     

Changes in Satisfaction with Meaningful Activities and Onset of Depressive Symptoms among Community-Dwelling Japanese Older Adults: A Population-Based Study Before and During the COVID-19 Pandemic

ObjectivesThis study aimed to clarify the association between changes in satisfaction with meaningful activities and the occurrence of depressive symptoms before and during the coronavirus disease 2019 (COVID-19) pandemic.DesignA population-based prospective cohort study (Tarumizu Study).Setting and ParticipantsA total of 231 community-dwelling older adults aged ≥65 years without depressive symptoms at baseline.MethodsThe participants completed baseline (June to December 2018, before the COVID-19 pandemic) and follow-up (September to December 2021, during the COVID-19 pandemic) assessments. Depressive symptoms were assessed using the 15-item Geriatric Depression Scale (GDS-15) and defined by a GDS-15 score of ≥5. Participants selected meaningful activities from the 95 activities included in the Aid for Decision-Making in Occupation Choice, and their satisfaction levels were evaluated. Satisfaction with the most meaningful activities was assessed as to whether it was maintained/improved or decreased at follow-up.ResultsIn the follow-up survey, 31 (14.3%) participants reported the occurrence of depressive symptoms. Compared with before the COVID-19 pandemic, the rates of meaningful activities during the COVID-19 pandemic decreased for interpersonal interaction and social life and increased for leisure, sports, self-care, and domestic life. Logistic regression analysis revealed that changes in satisfaction with meaningful activity were associated with the occurrence of depressive symptoms after adjusting for demographic variables, baseline GDS scores, cognitive and physical status, and instrumental activities of daily living (odds ratio, 2.78; 95% confidence interval, 1.17–6.59, P = .020).Conclusions and ImplicationsTo avoid decreasing satisfaction with meaningful activities, supporting older adults may be protective against the occurrence of depressive symptoms. Our findings highlight the need for health care professionals to not only encourage older adults to participate in activities for their mental health but also consider whether the activities are meaningful or satisfying for them.     

A Longitudinal Study of Food Insecurity on Obesity in Preschool Children

BackgroundObesity and its co-occurrence with household food insecurity among low-income families is a public health concern, particularly because both are associated with later adverse health consequences.ObjectiveOur aim was to examine the relationship between household food insecurity with and without hunger in infancy and later childhood with weight status at 2 to 5 years.DesignThis longitudinal study uses household food-security status, weight, and height data collected at the first infancy and last child (2 to 5 years) Special Supplemental Nutrition Program for Women, Infants, and Children visits. Household food security was based on parent/caretaker responses to a four-question subscale of the 18-item Core Food Security Module. Obesity was defined as sex-specific body mass index for age ≥95th percentile.Participants/settingA diverse (58.6% non-white) low-income sample of 28,353 children participating in the Massachusetts Special Supplemental Nutrition Program for Women, Infants, and Children (2001-2006); 24.9% of infants and 23.1% of children lived in food-insecure households and 17.1% were obese at their last child visit.Statistical analysisMultivariate logistic regression analyses assessed the association between household food-security status during the infant and child visits, and risk of preschool obesity, while controlling for child race/Hispanic ethnicity, sex, child and household size, maternal age, education, and prepregnancy weight. Interactions between these covariates and household food-security status were also examined. In cases of multiple comparisons, a Bonferroni correction was applied.ResultsPersistent household food insecurity without hunger was associated with 22% greater odds of child obesity (odds ratio=1.22; 95% CI 1.06 to 1.41) compared with those persistently food secure (P<0.05). Maternal prepregnancy weight status modified this association with children of underweight (adjusted odds ratio=3.22; 95% CI 1.70 to 6.11; P=0.003) or overweight/obese (adjusted odds ratio=1.34; 95% CI 1.11 to 1.62; P=0.03) mothers experiencing greater odds of child obesity with persistent household food insecurity without hunger compared with those with persistent household food security.ConclusionsThese results suggest that persistent household food insecurity without hunger is prospectively related to child obesity, but that these associations depend on maternal weight status. Vulnerable groups should be targeted for early interventions to prevent overweight and obesity later in life.     

Food insecurity and food choices in rural older adults with diabetes receiving nutrition education via telemedicine

ObjectiveTo evaluate differences between rural older adults with diabetes reporting the presence or absence of food insecurity with respect to meal planning, preparation, shopping, obesity, and glycemic control after receiving nutrition counseling through telemedicine.MethodsFood insecurity data were obtained by telephone survey (n = 74). Group differences for continuous variables were measured by t tests; categorical variables by Pearson chi-square tests.ResultsParticipants reporting mild food insecurity (23%) had higher body mass index (35.5 ± 7.1 kg/m² vs 30.5 ± 6.0 kg/m², P = .01) and lower household incomes (P = .03) and were more likely to consider cost of ingredients in food preparation compared to food-secure participants (P = .03). Most purchased fresh produce (97%) and considered the dietitian's advice when purchasing food. Both groups report similar adherence to dietitians' advice and had similar glycemic control.Conclusions and ImplicationsStrategies to address higher levels of obesity associated with food insecurity are needed.     

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.     

Food Insecurity and Sugar-Sweetened Beverage Consumption Among WIC-Enrolled Families in the First 1,000 Days

ObjectiveDetermine the association between household food insecurity and habitual sugar-sweetened beverage (SSB) consumption among Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)–enrolled families during the first 1,000 days.MethodsCross-sectional analysis of pregnant women and mothers of infants aged under 2 years in the WIC was performed. Families recruited sequentially at consecutive visits completed food insecurity and beverage intake questionnaires; estimated logistic regression models controlled for sociodemographic characteristics.ResultsOf 394 Hispanic/Latino mothers and 281 infants, 63% had household food insecurity. Food insecurity significantly increased odds of habitual maternal (unadjusted odds ratio (OR), 2.39; 95% CI, 1.27–4.47; P = .01) and infant SSB consumption (OR, 2.05; 95% CI, 1.15–3.65; P = .02), and the relationship was not attenuated by maternal age, education, or foreign-born status.Conclusions and ImplicationsFood insecurity increased odds of habitual SSB consumption in WIC families. Interventions to curb SSB consumption among WIC-enrolled families in the first 1,000 days in the context of household food insecurity are needed.     

Food Insecurity and Depression among US Adults: NHANES 2005–2016

A growing body of evidence suggests that food insecurity is associated with adverse mental health outcomes such as depression and anxiety. In this study, the relationship between food insecurity and depression was examined using data from the 2005–2016 National Health and Nutrition Examination Survey (NHANES). Food insecurity was assessed with the 18-item United States Food Security Survey Module with zero affirmative responses indicating high food security, 1 or 2 affirmative responses indicating marginal food security, and ≥3 affirmative responses indicating food insecurity. Depression was assessed with the Patient Health Questionnaire-9 with scores ≥10 indicating depression. Data were analyzed from 28,448 adult participants aged 20 or older. Food insecurity was present in 19.2% of the sample population (n = 5452). Food security status was significantly associated with gender, race, education level, marital status, smoking status, and BMI (Rao-Scott chi-square, p < 0.05). Fully food secure and very low food security adults experienced depression at a rate of 5.1% and 25.8%, respectively (Rao-Scott chi-square, p < 0.0001). Participants with very low food security had a significantly greater odds of depression than food secure adults, OR = 3.50 (95% CI: 2.98, 4.12). These findings suggest that food insecurity is a significant risk factors for depression in US adults over 20 years of age. To address this issue in our citizenry, police initiatives and public health interventions addressing both food access and mental health should be prioritized.     

The Differential Effects of Social Media on Depressive Symptoms and Suicidal Ideation Among the Younger and Older Adult Population in Hong Kong During the COVID-19 Pandemic: Population-Based Cross-sectional Survey Study

BackgroundSocial media has become a ubiquitous part of daily life during the COVID-19 pandemic isolation. However, the role of social media use in depression and suicidal ideation of the general public remains unclear. Related empirical studies were limited and reported inconsistent findings. Little is known about the potential underlying mechanisms that may illustrate the relationship between social media use and depression and suicidal ideation during the COVID-19 pandemic.ObjectiveThis study tested the mediation effects of social loneliness and posttraumatic stress disorder (PTSD) symptoms on the relationship between social media use and depressive symptoms and suicidal ideation, as well as the moderation effect of age on the mediation models.MethodsWe administered a population-based random telephone survey in May and June 2020, when infection control measures were being vigorously implemented in Hong Kong. A total of 1070 adults (658 social media users and 412 nonusers) completed the survey. Structural equation modeling (SEM) and multigroup SEM were conducted to test the mediation and moderation effects.ResultsThe weighted prevalence of probable depression was 11.6%; 1.6% had suicidal ideation in the past 2 weeks. Both moderated mediation models of depressive symptoms (χ²₆₂=335.3; P<.05; comparative fit index [CFI]=0.94; nonnormed fit index [NNFI]=0.92; root mean square error of approximation [RMSEA]=0.06) and suicidal ideation (χ²₃₄=50.8; P<.05; CFI=0.99; NNFI=0.99; RMSEA=0.02) showed acceptable model fit. There was a significantly negative direct effect of social media use on depressive symptoms among older people (β=–.07; P=.04) but not among younger people (β=.04; P=.55). The indirect effect via PTSD symptoms was significantly positive among both younger people (β=.09; P=.02) and older people (β=.10; P=.01). The indirect effect via social loneliness was significant among older people (β=–.01; P=.04) but not among younger people (β=.01; P=.31). The direct effect of social media use on suicidal ideation was not statistically significant in either age group (P>.05). The indirect effects via PTSD symptoms were statistically significant among younger people (β=.02; P=.04) and older people (β=.03; P=.01). Social loneliness was not a significant mediator between social media use and suicidal ideation among either age group (P>.05).ConclusionsSocial media may be a “double-edged sword” for psychosocial well-being during the COVID-19 pandemic, and its roles vary across age groups. The mediators identified in this study can be addressed by psychological interventions to prevent severe mental health problems during and after the COVID-19 pandemic.     

Low Testosterone Levels,Depressive Symptoms,and Falls in Older Men: A Cross-Sectional Study

ObjectivesWhile several studies have cited a potential association between testosterone deficiency and risk of falls among community-dwelling older men, evidence for such an association is conflicting. Depressive symptoms, which occasionally accompany testosterone deficiency but which are often neglected as associated symptoms, may actually provoke falls independent of or jointly with testosterone deficiency. We examined the association between testosterone levels, depressive symptoms, and falls, and assessed the joint effect of testosterone levels and depressive symptoms on falls among older men.Design, Setting, and ParticipantsData for this cross-sectional study were obtained from 869 men aged over 60 years who participated in health check-ups conducted in 2010 from 2 Japanese municipalities. Salivary testosterone (sT) levels were measured using an enzyme-linked immunosorbent assay, and depressive symptoms were assessed via the short form of the Center for Epidemiologic Studies Depression Scale.Main outcome measuresSelf-reported “any fall” over the 1-month period.ResultsAmong the total of 482 participants analyzed (median age, 70 years), 10.8% reported any fall. On comparison between 90th percentile sT levels and lower levels, our logistic regression model with restricted cubic splines showed that lower sT levels were associated with an increased likelihood of suffering any fall after adjustment for sociodemographic characteristics, comorbidities, and mobility function. For example, 5th percentile sT was associated with any fall [adjusted odds ratio (OR), 4.23; 95% confidence interval (CI), 1.66–10.8]. Depressive symptoms were also strongly associated with any fall [adjusted OR, 3.49 (95% CI, 1.52–8.04)]. We noted no apparent interaction of sT and depressive symptoms with falls (P = .079), suggesting that the joint effect of testosterone deficiency and depressive symptoms on falls was multiplicative. Indeed, compared with a combination of 90th percentile sT values and no depressive symptoms, adjusted OR for any fall in a combination involving 5th percentile sT and depressive symptoms was 14.8-fold (95% CI, 3.76–58.0).ConclusionsOur findings indicated that both relatively low testosterone levels and presence of depressive symptoms were independently associated with falls among older men. Causality of these associations should be confirmed in future prospective studies.     

Vitamin B-6 and depressive symptomatology,over time,in older Latino adults

Background: Low vitamin B-6 status has been linked to depressive symptomatology. We examined the longitudinal association of vitamin B-6 status with depressive symptomatology across 3-time points over ～5–7 years in a cohort of older Hispanic adults.

Methods: We used two-level hierarchical linear regression models for continuous outcomes. Vitamin B-6 status was associated with depressive symptomatology across these time points.

Results: Plasma pyridoxyl-5-phosphate (PLP) concentration, a time-varying predictor, was significantly associated with depressive symptomatology. Study participants with PLP deficiency, vs. optimal PLP, had higher baseline depressive symptoms (Center for Epidemiologic Studies-Depression Scale (CES-D) score of 22?±?14, vs. 20?±?13); this differential remained constant over time and persisted after controlling for age, sex, education, body mass index, smoking and alcohol use, other relevant nutritional factors, perceived stress, stressful life events, allostatic load, and use of antidepressant medication. However, PLP concentration was not associated with the rate of change in depressive symptomatology over time.

Conclusions: Suboptimal plasma PLP is associated with higher depressive symptomatology in older Hispanic of Puerto Rican descent and this appears to persist over time. Our data suggest that identification and treatment of vitamin B-6 deficiency may be a useful preventive approach in this population.     

Household food security status and its associated factors in Baft-Kerman,IRAN: a cross-sectional study

ABSTRACT

Food insecurity is prevalent in both developed and developing countries, which has considerable health impacts on the social, physical, and psychological status. This study aimed to examine the food security status and its related sociodemographic factors among the households living in Baft city of Iran. A sample of 702 households was selected by a simple random sampling method from January to March 2017. Using U.S. Department of Agriculture Food Security questionnaire, 34.3% of households showed some degree of food insecurity. Lower household size (OR = 0.84, CI: 0.73–0.97, P = .02), higher welfare facilities (OR = 1.55, CI: 1.32–1.81, P < .001), educational levels of the mothers and their spouse (being diploma as compared to under-diploma) (OR = 1.57, CI: 0.98–2.53, P = .04 and OR = 1.65, CI: 1.05–2.57, P = .02), governmental employment as compared to unemployment of the spouse (OR = 1.85, CI: 1.14–2.99, P = .01), and house ownership (rent compared to owner house; OR = 0.41, CI: 0.21–0.81, P = .01) were significantly associated with food security. The findings showed food insecurity was associated with some sociodemographic factors among households in Baft. These findings demonstrate that the government needs to continue its efforts to provide appropriate funding for population-based programs and policies, to enhance food security of the people living in this city.