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BACKGROUND: Ultra-processed foods contribute to risks of obesity and cardiometabolic disease, and higher intakes have been observed in low-income populations in the United States. Consumption of ultra-processed foods may be particularly higher among individuals experiencing food insecurity and participating in the Supplemental Nutrition Assistance Program (SNAP). OBJECTIVES: Using data from the 2007–2016 NHANES, we examined the associations between food insecurity, SNAP participation, and ultra-processed food consumption. METHODS: The study population comprised 9190 adults, aged 20–65 y, with incomes ≤300% of the federal poverty level (FPL). Food insecurity was assessed using the Household Food Security Survey Module and SNAP participation over the past 12 mo was self-reported. Dietary intake was measured from two 24-h dietary recalls. Ultra-processed food consumption (percentage of total energy intake) was defined using the NOVA food classification system. Linear regression models were used to examine the associations between food insecurity, SNAP participation, and ultra-processed food consumption, adjusting for sociodemographic and health characteristics. RESULTS: More severe food insecurity was associated with higher intakes of ultra-processed foods (P-trend = 0.003). The adjusted means of ultra-processed food intake ranged from 52.6% for adults with high food security to 55.7% for adults with very low food security. SNAP participation was also associated with higher intakes of ultra-processed foods (adjusted mean: 54.7%), compared with income-eligible participants (adjusted mean: 53.0%). Furthermore, the association between food insecurity and ultra-processed foods was modified by SNAP participation (P-interaction = 0.02). Among income-eligible nonparticipants and income-ineligible nonparticipants, more severe food insecurity was associated with higher consumption of ultra-processed foods. Among SNAP participants, the association between food insecurity and consumption of ultra-processed foods was nonsignificant. CONCLUSION: In a nationally representative sample of adults, food insecurity and SNAP participation were both associated with higher levels of ultra-processed food consumption.

Objective:Household food insecurity is associated with CVD risk factors in low-income adults, but research on these associations among adolescents is inconsistent. This study investigates whether household and child food insecurity is associated with CVD risk factors in lower-income adolescents.Design:Cross-sectional. Multivariable linear regression assessed the association between household and child food security and CVD risk factors. Household and child food security was measured using the US Food Security Survey Module. The analyses were adjusted for adolescent’s age, sex, race/ethnicity, smoking status, physical activity and sedentary time, as well as household income and the head-of-household’s education and marital status.Setting:The USA.Participants:The sample was comprised of 2876 adolescents, aged 12–17 years, with household incomes at or below 300 % federal poverty line from the National Health and Nutrition Examination Survey cycles 2007–2016.Results:The weighted prevalence of household food insecurity in the analytic sample was 33·4 %, and the weighted prevalence of child food insecurity was 17·4 %. After multivariable adjustment, there were no significant associations between household and child food insecurity and BMI-for-age Z-score, systolic and diastolic blood pressure, HDL-cholesterol, total cholesterol, fasting TAG, fasting LDL-cholesterol and fasting plasma glucose.Conclusions:Despite observed associations in adults, household food insecurity was not associated with CVD risk factors in a national sample of lower-income adolescents. Child food insecurity was also not associated with CVD risk factors. More research should be conducted to confirm these associations.

BACKGROUND: Food insecurity, a state of not being able to consistently access nutritious food due to financial constraints, has been associated with poor dietary intake among college students. The extent to which campus food resources contribute to this association is unknown. OBJECTIVES: This study examined the association between food insecurity and dietary intake in a sample of undergraduate students with unlimited meal plans and dining hall access at a large, public Midwestern university. DESIGN: The study design is cross-sectional. The data used are baseline data from part of a broader sugar-sweetened beverage intervention study that were collected using a Qualtrics survey prior to the intervention. PARTICIPANTS/SETTING: The sample consisted of 1,033 undergraduate students recruited from three dining halls. The data were collected in November 2018. MAIN OUTCOME MEASURES: Food security was assessed using the 6-item Short Form Food Security Survey Module. Dietary intake was assessed using the National Cancer Institute 26-item Dietary Screener Questionnaire and the Beverage Intake Questionnaire-15. STATISTICAL ANALYSES PERFORMED: Generalized linear regression models were used to examine differences in dietary intake by students’ food security status, adjusting for students’ sociodemographic characteristics. RESULTS: In the sample, 14% of students were food-insecure. After adjusting for sociodemographic variables, food-insecure students reported 9% lower intake of fruits (P=0.02), 9% lower intake of vegetables (P

OBJECTIVES: Food insecurity, a state of not being able to consistently access nutritious food, is an issue that 43% of students on college campuses experience. This study examines the associations between food insecurity and dietary intake in a sample of undergraduate students at a large, public Midwestern university. METHODS: A Qualtrics survey was completed by 1033 students, recruited from three dining halls as part of a different sugar-sweetened beverage intervention study. Baseline data, collected prior to the intervention, were used in the present study. Food security was assessed using the 6-item Short Form Food Security Survey Module and dietary intake was assessed using the National Cancer Institute 26-item Dietary Screener Questionnaire and the Beverage Intake Questionnaire-15. Generalized linear regression models were used to examine differences in dietary intake by student's food security status. RESULTS: After adjusting for sociodemographic variables, food-insecure students reported 9% lower intake of fruits, 9% lower intake of vegetables, 10% higher intake of dairy, 6% higher intake of total added sugars, 10% higher intake of added sugars from sugar-sweetened beverages, 4% higher intake of calcium, and 4% lower intake of fiber, compared to food-secure students. With respect to beverage intake, food-insecure students had 55% higher intake of fruit drinks, 148% higher intake of energy drinks, 129% higher intake of sweetened teas, 46% higher intake of flavored milk, 54% higher intake of total sugar-sweetened beverages, and 66% higher intake of diet soda. CONCLUSIONS: Despite having similar access to university dining halls, there were significant differences in the diets of college students by food security status, providing more reason to increase food insecurity awareness among college students and contribute to initiatives to alleviate food insecurity, such as on-campus food pantry programs. FUNDING SOURCES: This study was supported by a grant from Poverty Solutions at the University of Michigan.

The high cost of fruit and vegetables can be a barrier to healthy eating, particularly among lower-income households with children. We examined the effects of a financial incentive on purchases at a single supermarket by primary shoppers from low-income households who had at least one child. Participation in an in-store Cooking Matters event was requested for incentivized subjects but optional for their nonincentivized controls. The sample included but was not limited to Supplemental Nutrition Assistance Program participants. Compared to the controls, incentivized shoppers-who were given an immediate 50 percent discount on qualifying fruit and vegetables-increased weekly spending on those items by 27 percent; this change was for fresh produce. There was no change in purchases of frozen and canned produce or unhealthful foods. Estimated annual average daily consumption of fruit and vegetables by the incentivized shoppers and by one designated child per incentivized household did not change. Attendance at Cooking Matters events was low. These findings support financial incentive programs to increase fruit and vegetable purchasing but suggest that effective complementary approaches are needed to improve diet quality.

Safety-net hospitals serving populations with disproportionately high levels of poverty, food insecurity, and chronic disease can utilize innovative strategies to improve the health and environment of their communities. Boston Medical Center in Boston, Massachusetts, constructed an on-site rooftop farm to provide fresh produce for the hospital’s preventive food pantry, teaching kitchen, cafeterias, and inpatient meal services. This novel model can be replicated by other organizations aiming to alleviate food insecurity, encourage healthy eating, and promote environmental sustainability.

Introduction Cardiovascular disease is a leading cause of mortality in the U.S. Although the risk of cardiovascular disease can be mitigated substantially by following a healthy lifestyle, adhering to a healthy diet and other healthy behaviors are limited by reduced food security. This study aims to determine the association between food security and cardiovascular disease risk. Methods Three samples from the 2007–2014 National Health and Nutrition Examination Survey were examined: (1) 7,340 non-fasting adults (aged 40–79 years); (2) 13,518 non-fasting adults (aged 20–64 years); and (3) 6,494 fasting adults (aged 20–64 years). Food security was assessed using the U.S. Household Food Security Survey Module, with households categorized as having full, marginal, low, or very low food security. Regressions were conducted in 2018 to test the associations between food security status and odds of ≥20% 10-year cardiovascular disease risk among middle-aged to older adults (OR, 95% CI) and cardiovascular disease risk factors among all adults (β, 95% CI). Results Compared with adults with full food security, those with very low food security had higher odds of ≥20% 10-year cardiovascular disease risk (OR=2.36, 95% CI=1.25, 4.46), whereas those with marginal food security had higher systolic blood pressure (β=0.94 mmHg, 95% CI=0.09, 1.80). Compared with adults with full food security, adults with different levels of food security had higher BMIs (marginal: 0.76, 95% CI=0.26, 1.26; low: 0.97, 95% CI=0.34, 1.60; and very low: 1.03, 95% CI=0.44, 1.63) and higher odds of current smoking (marginal: OR=1.43, 95% CI=1.17, 1.75; low: OR=1.47, 95% CI=1.22, 1.77; and very low: OR=1.95, 95% CI=1.60, 2.37). Conclusions Adults with food insecurity have elevated cardiovascular disease risk factors and excess predicted 10-year cardiovascular disease risk. Substantially improving food security may be an important public health intervention to reduce future cardiovascular disease in the U.S. population.

Objective Few Americans meet national recommendations for fruit and vegetable (FV) consumption, and the high price of fresh produce is a commonly cited barrier. We conducted a randomized controlled trial to determine if a same-day, two-for-one FV coupon (Double Bucks) combined with a point-of-purchase nutrition education program (Cooking Matters) would increase FV purchases and consumption among low-income families who were regular customers of a rural Maine supermarket. Description We randomized 605 parents who regularly shopped at a Maine supermarket to a six-month intervention (Double Bucks on FV up to $10/day plus Cooking Matters) or a control arm. All participants were given a study loyalty card, which provided a 5% discount on groceries and tracked purchases during the three-month baseline and six-month intervention periods. The primary outcome was change in weekly spending on FV from baseline to follow-up in intervention and control groups. We also compared changes from baseline to follow-up in daily servings of FV among parents and children using a 135-item food frequency questionnaire. A baseline survey asked about the household's participation in the Supplemental Nutrition Assistance Program (SNAP), income, and food insecurity. Subgroup analyses compared intervention effects by SNAP participation. Evaluation At baseline, half of participants reported food insecurity. Overall, 52% were income-eligible for SNAP, and 32% participated in SNAP. Cooking Matters participation was low (11%). Compared to control, the intervention group increased weekly spending on FV by 23% ($2.23, 95% CI = $1.00, $3.46); among SNAP participants, the intervention group increased weekly spending by 43% ($2.17, 95% CI = $0.84, $3.50). Preliminary analyses revealed no overall change in FV consumption among parents or children. Conclusions and Implications Supermarket financial incentives increase household purchases of FV among SNAP and non-SNAP participants, with no evidence of increased spending on other, unhealthful foods and beverages.