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BACKGROUND/OBJECTIVES: School meals are an important source of nutrition for children and have been found to help mitigate food insecurity. This study evaluated the association between food insecurity and school meal participation and whether parental perceptions about school meals differ by food security status. METHODS: In May 2022, 1110 Californian parents of K-12 students shared their perceptions about school meals, including meal quality, healthiness, stigma, and benefits, as well as their childs participation in school meals, in an online survey. Household food security was determined using the USDA 6-item module. Logistic and Poisson regression models were used for analysis. RESULTS: The prevalence of household food insecurity was 56.2% (69.6% in households of students eligible for free meals, 55.9% in reduced-price, and 38.3% in non-eligible). Many of the reported benefits of school meals (saving families money and time) were equally highly endorsed by parents with and without food insecurity (p > 0.05). Parents reporting food insecurity had less favorable perceptions of school meals and perceived more stigma (p < 0.05). Food insecurity was positively associated with breakfast participation, especially among elementary school students and students not eligible for free or reduced-price meals (FRPMs) (p < 0.05). CONCLUSIONS: Food insecurity is prevalent among California families with school-age children, even in families not eligible for federal FRPMs. Food-insecure households have more negative perceptions of school meals and experience more stigma, though they also report higher breakfast participation. Improving school meal quality and appeal, ensuring parents are familiar with meal quality and healthfulness, and reducing stigma may ease food insecurity while improving childrens health.

Objective: Food insecurity is a prevalent social risk among emergency department (ED) patients. Patients who may benefit from food insecurity resources may be identified via ED-based screening; however, many patients experience difficulty accessing resources after discharge. Co-locating resources in or near the ED may improve utilization by patients, but this approach remains largely unstudied. This study characterized the acceptance and use of a food voucher redeemable at a hospital food market for patients who screened positive for food insecurity during their ED visit.Methods: This prospective cohort study, conducted at a single county-funded ED, included consecutive adult patients who presented on weekdays between 8 AM–8 PM from July–October 2022 and consented to research participation. We excluded patients who required resuscitation on arrival or could not provide written informed consent in English. Study participants completed a paper version of the two-question Hunger Vital Sign screening tool, administered by research staff. Participants who screened positive received a uniquely numbered $30 food voucher redeemable at the hospital’s co-located food market. Voucher redemption was quantified through regular evaluation of market receipt records at 30-day intervals. The primary outcome was the proportion of redeemed vouchers. Secondary outcomes included the proportion of participants screening positive for food insecurity, proportion of participants accepting vouchers, and associated descriptive statistics.Results: Of the 396 eligible individuals approached, 377 (95.2%) consented and completed food insecurity screening. Most were middle-aged (median 53 years, interquartile range 30–58 years), 191 were female (50.4%), 242 were Black (63.9%), and 343 were non-Hispanic (91.0%). Of the participants, 228 (60.2%) screened positive for food insecurity and 224 received vouchers (98.2%), of which 86 were redeemed (38.4%) a median of nine days after the ED visit.Conclusion: A high proportion of participants screened positive for food insecurity and accepted food vouchers; however, less than half of all vouchers were redeemed at the co-located food market. These results imply ED food voucher distribution for food insecurity is feasible, but co-location of resources alone may be insufficient in addressing the social risk and alludes to a limited understanding of facilitators and barriers to resource utilization following ED-based social needs screening.

Catherine Bertini, a leader in addressing global hunger, discusses the challenges of achieving zero hunger by 2030. Currently, 800 million people are food-insecure due to poverty, conflicts, climate issues, and the COVID-19 pandemic. The goal of reaching net-zero greenhouse gas emissions by 2050 poses a challenge, as agriculture contributes a quarter of all emissions. Efforts are being made to develop climate-resilient African crops and reduce negative impacts from the agricultural industry. The text emphasizes the importance of proactive measures to mitigate the effects of climate change on food security, investing in pre-mitigation efforts, and supporting local food systems. It also highlights the role of women in food and climate issues and the recent recognition of food's importance in climate discussions. The text concludes by discussing the food situation in Gaza and the need for an end to war to ensure food delivery to the region. [Extracted from the article]

ObjectivesUnhealthy diets and inadequate exercise are associated with chronic health conditions and excess mortality. Older African Americans do not meet dietary and exercise guidelines, and this may have worsened during the COVID-19 pandemic due to individual and environmental factors, including food insecurity. Studies evaluating these dynamics are essential for developing interventions. This narrative details a study protocol and data collection experiences during the pandemic.MethodsParticipants > 55 years African American old completed detailed food frequency, exercise, and food access questionnaires between October 2020 and July 2021. Observations of the study administrators (authors of this manuscript) for the duration of the study are presented. Details on the study design and reflections on the opportunities, challenges, and lessons learned are summarized. Future manuscripts will report data analysis of study findings.ResultsA total of 123 older African American adults participated in the study, and 118 (70% female) completed all three questionnaires. More than 50% of the participants had at least two primary chronic conditions. About 85% were fully vaccinated against COVID-19. Applying community-based participatory approaches, leveraging partnerships, and exercising flexibility approaches were pivotal to successfully implementing the study protocol.ConclusionsDespite challenges related to the COVID-19 pandemic, detailed data on older African American adults' diet and exercise habits were obtained. Our study design and experiences will benefit future researchers. More importantly, results from our study will inform interventions and policies aimed at minimizing consequences associated with poor diet and exercise habits during the pandemic among this vulnerable population.

BackgroundSocial care integration refers to the incorporation of activities into health systems that assist patients with health-related social needs (HRSNs) that negatively impact the health outcomes of their patients, such as food insecurity or homelessness. Social care integration initiatives are becoming more common. The COVID-19 pandemic strained health systems while simultaneously increasing levels of unmet social needs.ObjectiveTo describe the effects of the COVID-19 pandemic on established social care delivery in a primary care setting.DesignWe used qualitative semi-structured interviews of stakeholders to assess barriers and facilitators to social care delivery in the primary care setting during the COVID-19 health emergency. Data was analyzed using a hybrid inductive/deductive thematic analysis approach with both the Consolidated Framework for Implementation Research (CFIR) and the Screen-Navigate-Connect-Address-Evaluate model of social care integration.SettingTwo safety-net, hospital-based primary care clinics with established screening for food insecurity, homelessness, and legal needs.ParticipantsSix physicians, six nurses, six members of the social work team (clinical social workers and medical case workers), six community health workers, and six patients (total N = 30) completed interviews.ResultsFour major themes were identified. (1) A strained workforce experienced challenges confronting increased levels of HRSNs. (2) Vulnerable populations experienced a disproportionate negative impact in coping with effects of the COVID-19 pandemic on HRSNs. (3) COVID-19 protections compounded social isolation but did not extinguish the sense of community. (4) Fluctuations in the social service landscape led to variable experiences.ConclusionsThe COVID-19 pandemic disrupted established social care delivery in a primary care setting. Many of the lessons learned about challenges to social care delivery when health systems are strained are important considerations that can inform efforts to expand social care delivery.

INTRODUCTION: Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common chronic liver disease among US children. Studies have associated food insecurity with MASLD in adults, but there are few studies of pediatric MASLD, particularly in high-risk populations. We assessed the impact of household food insecurity at 4 years of age on MASLD in Latinx children. METHODS: Using a prospective cohort design, Latina mothers were recruited during pregnancy and followed with their children until early to mid-childhood. Our primary exposure was household food insecurity at 4 years of age measured using the validated US Household Food Security Food Module. Our primary outcome, MASLD, was defined as alanine transaminase (ALT) ≥95th% for age/gender plus body mass index (BMI) ≥85% at time of ALT measurement (assessed between ages 5-12). We used multivariable logistic regression models to test for independent associations between household food insecurity and pediatric MASLD. RESULTS: Among 136 children, 28.7% reported household food insecurity at 4 years of age and 27.2% had MASLD in early to middle childhood. Approximately 49% of children with MASLD and 21% of children without MASLD were food insecure (p

Food insecurity is highly prevalent and linked to poorer diet and worse metabolic outcomes. Food insecurity can be stressful, and could elicit chronic psychological and physiological stress. In this study, we tested whether stress could be used to identify those at highest risk for worse diet and metabolic measures from food insecurity. Specifically, we hypothesized that cortisol (a physiological marker of stress) and perceived psychological stress would amplify the link between food insecurity and hyperpalatable food intake as well as metabolic measures. In a sample of 624 Black and White women aged 36-43 who participated in the NHLBI Growth and Health Study's midlife assessment, we assessed associations between food insecurity with hyperpalatable food intake (high fat + high sodium foods; high fat + high sugar foods; and high carbohydrate + high sodium foods), and metabolic measures (fasting glucose, insulin resistance, and waist circumference). We found that food insecurity was associated with higher levels of perceived stress (R2 = 0.09), and greater intake of high fat + high sugar (hyperpalatable) foods (R2 = 0.03). In those with higher cumulative cortisol (as indexed by hair cortisol), food insecurity was associated with higher levels of fasting glucose. Neither cortisol nor perceived stress moderated any other relationships, and neither variable functioned as a mediator in sensitivity analyses. Given these largely null findings, further research is needed to understand the role stress plays in the chronic health burdens of food insecurity.

Background: Food insecurity rates drastically increased during the COVID-19 pandemic contributing to high demand for emergency nutrition assistance. Prior research indicates emergency food distribution centers mainly offer food with limited nutritional value; since nutritional status may be worse among food insecure families, it is important to conduct research to inform policy and programmatic strategies to address both food insecurity and nutrition-related health disparities during a state of emergency.Purpose: The study objectives were to: (1) assess the nutritional environment of emergency food distribution centers in the San Joaquin Valley, CA; (2) identify challenges food distribution centers encountered during the pandemic; and (3) provide policy and programmatic recommendations to improve access to and the availability of nutritious food to low-income communities.Methods: A nutritional assessment was conducted with 19 emergency food centers in the San Joaquin Valley, California. A modified version of the valid and reliable Nutrition Environment Food Pantry Assessment Tool (NEFPAT) was self-administered by food pantries and banks during the pandemic. The six NEFPAT objectives were included, and we developed a seventh component to capture data on challenges encountered during the COVID-19 pandemic. Challenges of distribution sites were identified and differentiated by type of organization (i.e., food bank, food pantry, church).Results: A total of 19 completed site assessments from 7 counties are included in the analysis. Using the NEFPAT classification score, all were either bronze (16%) or silver (84%). Analyses were stratified by the type of emergency food organization: church (47%) or other food pantry (53%). All sites (i.e., church and other pantries) reported experiencing a decrease in volunteers and staff. However, food pantries experienced an increase in quantity of clients while church pantries struggled with client retention. Logistical challenges were also mentioned, pantries experienced inconsistent food donations. Others expressed high levels of concern about COVID-19 safety but managed to remain open by using a drive-thru distribution model and promoting social distancing with limits on the number of clients allowed inside a building at a time.Conclusion: Policy recommendations include increasing funding to smaller charitable nutrition assistance sites to support fresh produce access and funding for the implementation of nutrition policy guidelines to improve the food environment. Programmatic recommendations include the adoption for a nutrition ranking system for food pantries, implementation of nudges to improve the selection of healthier food items, and use of valid and reliable data collection instruments to inform decisions to tailor food options that are aligned with the medical/health and social needs of food pantry clients.

Food and/or housing instability (FHI) has been minimally examined in post-9/11 US veterans. A randomly selected nationally representative sample of men and women veterans (n = 38,633) from the post-9/11 US veteran population were mailed invitation letters to complete a survey on health and well-being. Principal component analysis and multivariable logistic regression were used to identify FHIs key constructs and correlates for 15,166 men and women respondents (9524 men, 5642 women). One-third of veterans reported FHI; it was significantly more likely among women than men (crude odds ratio = 1.31, 95% CI:1.21-1.41) and most prevalent post-service (64.2%). Mental Health/Stress/Trauma, Physical Health, and Substance Use were FHIs major constructs. In both sexes, significant adjusted associations (p < 0.01) were found between FHI and homelessness, depression, adverse childhood experiences, low social support, being enlisted, being non-deployed, living with seriously ill/disabled person(s), and living in dangerous neighborhoods. In men only, posttraumatic stress disorder (adjusted odds ratio (AOR) = 1.37, 95% CI:1.14-1.64), cholesterol level (elevated versus normal, AOR = 0.79, 95% CI:0.67-0.92), hypertension (AOR = 1.25, 95% CI:1.07-1.47), and illegal/street drug use (AOR = 1.28, 95% CI:1.10-1.49) were significant (p < 0.01). In women only, morbid obesity (AOR = 1.90, 95%CI:1.05-3.42) and diabetes (AOR = 1.53, 95% CI:1.06-2.20) were significant (p < 0.05). Interventions are needed that jointly target adverse food and housing, especially for post-9/11 veteran women and enlisted personnel.

BACKGROUND: Individual adverse social determinants of health are associated with increased risk of diabetes in pregnancy, but the relative influence of neighborhood or community-level social determinants of health is unknown. OBJECTIVE: This study aimed to determine whether living in neighborhoods with greater socioeconomic disadvantage, food deserts, or less walkability was associated with having pregestational diabetes and developing gestational diabetes. STUDY DESIGN: We conducted a secondary analysis of the prospective Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-To-Be. Home addresses in the first trimester were geocoded at the census tract level. The exposures (modeled separately) were the following 3 neighborhood-level measures of adverse social determinants of health: (1) socioeconomic disadvantage, defined by the Area Deprivation Index and measured in tertiles from the lowest tertile (ie, least disadvantage [T1]) to the highest (ie, most disadvantage [T3]); (2) food desert, defined by the United States Department of Agriculture Food Access Research Atlas (yes/no by low income and low access criteria); and (3) less walkability, defined by the Environmental Protection Agency National Walkability Index (most walkable score [15.26-20.0] vs less walkable score [

BACKGROUND: Food insecurity and metabolic diseases both disproportionately affect Hispanic children. Cross-sectional studies have linked food insecurity with adverse cardiometabolic markers, including elevated plasma triglycerides and glucose concentrations. However, the association between changes in food insecurity and changes in cardiometabolic markers in children remains to be explored. Furthermore, few studies have assessed the impact of school-based nutrition interventions on household food insecurity. OBJECTIVE: The objectives of this study are to assess the effect of the TX Sprouts intervention on household food insecurity and to examine the association between changes in household food insecurity and changes in cardiometabolic markers over 1 academic year. METHODS: This secondary analysis used data from TX Sprouts, a cluster-randomized school-based gardening, cooking, and nutrition trial. The study enrolled 3rd-5th-grade students from 16 schools that served primarily (>50%) Hispanic families with low income in Austin, TX. Participants (n = 619) provided household food insecurity data and fasting lipid panels at both baseline and postintervention, ∼9 mo following. RESULTS: There was no intervention effect on household food insecurity. Independent of the intervention, a 1-point increase in food insecurity, indicative of becoming more food insecure, was associated with a 2.61 mg/dL increase in triglycerides (P = 0.001; 95% CI: 1.04, 4.19) at follow-up. Children who were food insecure at baseline and became food secure at follow-up had a mean 5.05 mg/dL decrease in triglycerides compared with a 7.50 mg/dL increase in triglycerides in children who remained food insecure throughout (95% CI: -23.40, -1.71, P = 0.023). There were no other associations between changes in food insecurity and cardiometabolic markers. CONCLUSION: Although the intervention did not improve food insecurity, reductions in food insecurity over 9 mo were associated with improved cardiometabolic markers in high-risk children, emphasizing the need for interventions targeting food insecurity. The study is registered at clinicaltrials.gov under NCT02668744 (https://classic. CLINICALTRIALS: gov/ct2/show/NCT02668744).

This study investigates how the landscape of sex work in Dar es Salaam, Tanzania, evolved in the context of the COVID-19 epidemic. Using a mixed-methods approach, the analysis triangulates data from quantitative and qualitative sources to quantify shifts in income, demand, and client frequency and describe female sex workers perspectives on their work environment. The COVID-19 restrictions introduced in early 2020 resulted in dramatic decreases in sex work income, leading to extreme financial vulnerability, food insecurity, and challenges in meeting other basic needs such as paying rent. However, in a 2021 follow-up survey, sex workers reported the summer of 2021 as a key turning point, with the demand for sex work rebounding to closer to pre-pandemic levels. Notably, despite the average number of unique weekly clients not yet having fully rebounded, by 2021 the price per client and the total monthly sex work income had returned to pre-pandemic levels. This may potentially be explained by an increased number of repeat clients, which represented a larger proportion of all clients during the COVID-19 pandemic.

We examined associations between adolescent self-reported hunger, health risk behaviors, and adverse experiences during the 2018-2019 school year. Youth Risk Behavior Survey data were pooled from 10 states. Prevalence ratios were calculated, and we assessed effect measure modification by sex. The prevalence of self-reported hunger was 13%. Self-reported hunger was associated with a higher prevalence of every health risk behavior/adverse experience analyzed, even after adjusting for sex, grade, and race/ethnicity. Sex did not modify associations. Findings underscore needs for longitudinal research with more robust measures of adolescent food insecurity to clarify the temporality of relationships.

In the United States, college students experience disproportionate food insecurity (FI) rates compared to the national prevalence. The experience of acute and chronic FI has been associated with negative physical and mental health outcomes in this population. This narrative review aims to summarize the current methodologies for assessing health outcomes associated with the experience of FI in college students in the United States. To date, assessing the health outcomes of FI has predominately consisted of subjective assessments, such as self-reported measures of dietary intake, perceived health status, stress, depression, anxiety, and sleep behaviors. This review, along with the emergence of FI as an international public health concern, establishes the need for novel, innovative, and objective biomarkers to evaluate the short- and long-term impacts of FI on physical and mental health outcomes in college students. The inclusion of objective biomarkers will further elucidate the relationship between FI and a multitude of health outcomes to better inform strategies for reducing the pervasiveness of FI in the United States college student population.

The relationship between food insecurity and transactional sex is well recognized, but less is known about this relationship among adolescents. We analyzed cross-sectional baseline data from 3,130 female secondary students aged 12-19 enrolled in a three-arm, cluster randomized controlled trial to examine the association between food insecurity and transactional sex. The explanatory variable was food security and the outcome was ever engaging in transactional sex. Over one quarter (28.7%) reported any food insecurity and 1.9% of all participants (9.6% of sexually active participants) reported ever engaging in transactional sex. In adjusted models, ever experiencing any food insecurity was associated with a higher prevalence of ever transactional sex (PR: 1.60; 95% CI: 1.02, 2.49) compared to little to no food insecurity. These results provide insight into potential predictors of higher-risk sexual behavior in Rwanda; they also provide policy-makers with populations with whom to intervene on upstream determinants of transactional sex, notably poverty and food insecurity.

In a context of urban precarity and food insecurity, our research examines how Syrian women in Istanbul (Turkey) (re-)create “Syrian cultural foods” as part of fulfilling gendered expectations for homemaking. Fleeing civil war since 2011, Syrians find safety in Turkey, but they struggle with a financially and politically insecure temporary protection status making the daily act of cooking a significant challenge. In contrast to research focused on sustainability primarily in terms of health and nutrition, we show the important role that culture plays in determining what food is considered sustaining. Specifically, we identify “culinary sustainability” strategies which are culturally embedded food practices that foster resilience for migrants in a new setting. Based on semi-structured interviews and participant observations in the kitchens of Syrian women in Istanbul, we identify three strategies: 1) Homemade food practices, 2) Adjustment, and 3) Recycling. Addressing a burgeoning literature that tries to integrate sustainability and resilience studies, we show how each strategy corresponds to a feature of cultural resilience (engaging forms of resistance, adaptation and innovation). Under severe socio-economic constraints, Syrian women use creative adaptations to innovate tasty new ways of showing culinary care in a new country and an unfamiliar megacity, Istanbul. [ABSTRACT FROM AUTHOR]

We utilize a unique dataset comprising 1180 households affiliated with maize producers' organizations (POs) in the Rukwa and Ruvuma regions of Tanzania to analyze the adoption and impacts of hermetic storage technologies (HSTs) on the quantity of stored maize, measured in kilograms (QSM), and the Household Food Insecurity Access Scale (HFIAS). The study employs the logit and endogenous switching regression models to generate results. We find that, among other factors, the presence of HST vendors in the local community and training on proper HST usage are crucial in the adoption of HSTs among POs. Additionally, the usage of storage pesticides is negatively and significantly correlated with HST adoption. This suggests that farmers employing chemical insect pest control methods are less likely to adopt HSTs. The adoption of HSTs is shown to increase maize storage quantities by 40% and decrease household food insecurity by 43%. Further analysis based on the gender of the household head demonstrates that both female- and male-headed households benefit equally from the adoption of HSTs. The results advocate for the promotion of HSTs as a viable solution to mitigate household food insecurity among members of maize POs in Tanzania. [ABSTRACT FROM AUTHOR]

Food insecurity disproportionately affects smallholder farming households and within them women, who bear primary caregiving responsibilities and contend with time and resource constraints that heighten their vulnerability to adverse nutrition‐related health outcomes. This study cross‐sectionally investigates the association between food production practices, household consumer behaviour, and the experience of food insecurity with women's waist‐hip ratio (WHR), a key indicator of abdominal obesity, in a coastal community in Kenya. In total, 394 households were randomly selected from a list of farming households in Kaloleni and Rabai sub‐counties of Kilifi. Trained enumerators administered questionnaires to adult female family members who play a pivotal role in household management. Household dietary diversity scores (HDDS) were computed from 16 food groups consumed in the 7 days preceding the survey. Waist‐hip measurements focused on these females, representing vulnerable populations. Pathway‐based regression models were constructed using STATA version 13 (p < 0.05). Most households practised mixed farming (59.9%) and monocropping (73.2%) and most female respondents were widowed (75.1%) with limited education (73.1% had no formal education) and over 20 years of farming experience. Food insecurity was prevalent, affecting 80.7% of households. Limited dietary diversity was noted with an average HDDS of 9. The most commonly consumed foods were cereals, spices, condiments and beverages, while meat, eggs and fruits were infrequently eaten. An inverse association was observed between HDDS and WHR (standardised regression coefficient = −0.1328; p = 0.026) but while food insecurity was inversely associated with both HDD and WHR, these associations did not reach statistical significance (HDDS‐standardised regression coefficient −0.0294; p = 0.592: WHR‐standardised regression coefficient −0.0155; p = 0.791). Existing research has primarily addressed the undernutrition and hunger‐related impacts of food insecurity. The findings underscore the need to better understand the complex interplay between food insecurity and nutritional health, including markers of adiposity, to effectively promote health. [ABSTRACT FROM AUTHOR]

Aims Methods Results Conclusions Household food insecurity (FI) is a serious public health concern and disproportionately affects people living with chronic health conditions, undermining diabetes self‐management. Little is known about healthcare professionals' (HCPs) experiences of supporting people affected by diabetes and FI, and no national guidelines incorporate consideration of FI within UK diabetes care. A qualitative study of NHS HCPs' consideration of FI within diabetes care, and the extent to which it informs their clinical practice, was undertaken.Fifteen HCPs providing self‐management support to people with Type 1 or Type 2 diabetes in a Scottish Health Board took part in semi‐structured interviews. Data were analysed using a thematic framework approach informed by the Capability, Opportunity, Motivation and Behaviour (COM‐B) model of behaviour change.Although the potential impact of FI on diabetes self‐management was recognised, this important consideration was not currently core to their clinical practice. Enablers and barriers identified included: personal feelings about raising the issue, lack of knowledge of available resources, the patient‐practitioner relationship, and the wider socioeconomic environment. Practical suggestions to support HCPs included: specific training on communication, access to patient support information, use of a screening tool to assess FI, and building NHS‐third sector links.Our findings provide insight into cognitive factors, emotional processes and environmental systems impacting on HCPs' practice supporting individuals with diabetes and FI. Research with affected patients is needed to gain a better understanding of how to provide support within NHS settings. [ABSTRACT FROM AUTHOR]

Food insecurity in South Africa was critical prior to the COVID‐19 outbreak, but the problem deepened quickly during the pandemic when government controls caused job losses, a food supply collapse, and escalating hunger. The food and fuel price hikes and political instability that followed led to the July 2021 ‘unrest’, which left more than 350 people dead. Behind this lay a crisis within the governing African National Congress. In this paper, we draw on in‐depth interviews and ethnography with individuals working in food‐based livelihoods to investigate how people continued to secure food, and how rural food systems were affected. Against a backdrop of hunger, social unrest, and xenophobic hostility, we consider how people perceive the state in a rural area of KwaZulu‐Natal. We argue that weak governing institutions and South Africa's exposure to globally‐triggered spikes in food and fuel prices are leading to food insecurity. Hunger, in turn, is contributing to a crisis of legitimation for the state. [ABSTRACT FROM AUTHOR]

Food insecurity has broad detrimental impacts on college students, including failing grades, depression, and social disconnection. Social disconnection is concerning as students often use various support resources to manage food insecurity. Racial disparities in food insecurity are well documented in the literature. The purpose of the current study was to explore the relationship between constructs of emotional support and food insecurity among African American and White students. A validated electronic survey based on the Sense of Support Scale and the U.S. Food Security Scale was utilized for the study. Results indicated that specific constructs of emotional social support were associated with food insecurity (OR: 3.778; p =.011); (OR: −2.116; p =.036). Students who reported strong emotional ties were more likely to experience food insecurity (OR = − 3.837, p =.044). Findings implicate further campus outreach to all students. [ABSTRACT FROM AUTHOR]

Objective: This study assessed the impact of the COVID-19 pandemic on college students' nutrition, including dietary behaviors and food security status. Participants: Participants included 140 students between 18 and 25 years of age, who were enrolled in a college or university in the greater Houston area. Methods: Analyses included descriptive statistics, t tests, and ANOVAs to analyze differences in dietary behaviors by demographic variables, and chi-square tests to assess characteristics associated with food security status. Results: The majority of participants reported changing their diets due to the COVID-19 pandemic. There were no significant differences by demographics. However, there were significant differences in food security status by race/ethnicity and social class. Conclusion: This study identified changes and disparities in college students' dietary behaviors and food security status during the COVID-19 pandemic. Findings help inform future policy, programs, and research to address college students' nutrition during the ongoing COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Introduction One in four U.S. service members endorses food insecurity. The Supplemental Nutrition Program for Women, Infants, and Children (WIC) is an invaluable, underutilized resource that can increase access to nutritious food for families with children under 5 years of age. Our research sought to evaluate military family perceptions and engagement with the WIC program. Materials and Methods We conducted a mixed-method study, recruiting from a convenience sample of military families who applied for financial assistance for child care. An 18-question survey and follow-up focus groups assessed participant demographics and experiences with WIC. We utilized descriptive statistics ordinal logistic regression analyses for quantitative data analysis. For qualitative data, descriptive content analysis with constant comparison and inductive and deductive coding of interviews identified emerging themes. This study was approved by the Uniformed Services University of the Health Sciences Institutional Review Board. Results Among the 399 survey respondents, 25% were currently enrolled in WIC and 39% had been previously enrolled. Service members and their partners learned about WIC from a variety of sources, and there was no significant association between the branch of service or rank and WIC enrollment. There were 40 total participants in 10 completed focus groups. Six themes emerged: (1) Military-specific factors create unique circumstances related to WIC engagement; (2) the WIC program facilitates access to formula supplementation and nutritious foods for military families; (3) lack of program awareness and misinformation are top barriers to WIC engagement in military families; (4) stigma impacts WIC program enrollment and engagement; (5) logistics of enrollment can impact WIC engagement among military families; and (6) the military can support WIC enrollment and engagement through standardization, education, and leadership commitment. Conclusions Our findings suggest that unique circumstances related to military family life create a profound need for programs addressing food support, such as WIC. Interventions to improve WIC enrollment among military families need to be rooted in broad outreach efforts, not targeted at specific ranks, branches, or ages. Specific recommendations include increasing information dissemination, universally screening military families for WIC, decreasing logistical burdens, and involving military leadership. [ABSTRACT FROM AUTHOR]

Background: Food insecurity has been linked to higher rates of obesity. It has also been shown to diminish the effectiveness of weight loss strategies, including intensive lifestyle interventions. One essential component of food insecurity is having a geospatial disadvantage in access to healthy, affordable food, such as living within a food desert. This study aims to determine if food insecurity also impacts weight loss and nutritional outcomes in patients who underwent Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG). Methods: Clinical outcomes of patients who underwent RYGB or SG at Cleveland Clinic or affiliate regional hospitals in the United States from 2010 to 2018 were collected. Modified Retail Food Environmental Index (mRFEI) data was collected from the Center for Disease Control and merged with patient census tract data, allowing the patient cohort to be divided into those living in areas identified as food secure (mRFEI > 10%), food swamps (mRFEI = 1–10%), or food deserts (mRFEI = 0). Postoperative weight change was evaluated with quadratic growth mixture models and stratified by surgery type. Results: A total of 5097 patients were included in this study cohort, including 3424 patients who underwent RYGB and 1673 who underwent SG. The median duration of follow-up was 2.3 years (IQR 0.89–3.6 years). Food security status was not associated with postoperative weight change (RYGB p = 0.73, SG p = 0.60), weight loss nadir (RYGB p = 0.60, SG p = 0.79), or weight regain (RYGB p = 0.93, SG p = 0.85). Deficiencies in nutritional markers at 1–2 years after surgery were also not significantly different between food security groups. Conclusion: Despite the established relationship between food insecurity and obesity, food insecurity does not negatively impact weight loss or nutritional outcomes following RYGB or SG, demonstrating metabolic surgery as a powerful and equitable tool for treating obesity. Level of Evidence: IV. [ABSTRACT FROM AUTHOR]

Adolescent food insecurity is a salient adversity hypothesized to affect neural systems associated with increased impulsive behavior. Family environments shape how adverse experiences influence development. In this study, hypotheses were tested regarding the conjoint effects of food insecurity and family flexibility on impulsivity via alterations in connectivity between regions within the salience and central executive networks. Such alterations are reflected in resting‐state functional connectivity (rsFC) metrics between the anterior insula (AI) and the middle frontal gyrus (MFG). Hypotheses were tested in a longitudinal moderated mediation model with two waves of data from 142 adolescents (Time 1 [T1] Mage = 12.89, SD = 0.85; Time 2 [T2] Mage = 15.01, SD = 1.07). Data on past‐year household food insecurity, family flexibility, and rsFC were obtained at T1. Impulsivity was self‐reported by the adolescent at T1 and T2. Findings revealed that high T1 left‐to‐left rsFC between the AI and MFG was associated with increased impulsivity at T2. The interaction of family flexibility and food insecurity was associated with AI and MFG rsFC. In the context of low family flexibility, food insecurity was linked to high levels of AI and MFG rsFC. Conversely, in the context of optimal family flexibility, food insecurity was associated with low levels of AI and MFG rsFC. Conditional indirect analysis suggests that the links among food insecurity, rsFC, and impulsive behavior depend on family flexibility. Research Highlights: Adolescent food insecurity was associated with anterior insula and middle frontal gyrus connectivity only at certain levels of family flexibility.High family flexibility attenuated the link between food insecurity and neural connectivity, while low levels of family flexibility increased this risk.High left anterior insula and left middle frontal gyrus connectivity was associated with increased impulsivity 1 year later. [ABSTRACT FROM AUTHOR]

Purpose: Examine the predictors of food security and perceived stress among international students. Design: Cross-sectional Design. Settings: A public university in the Southwest United States. Subjects: Sample size of Seventy-three participants (≥18 years). Measures: Self-report measures of food insecurity and perceived stress. The U.S. Department of Agriculture (USDA) Adult Food Security Survey Module (AFSSM) to assess food security status, and the Perceived Stress Scale (PSS-10) questionnaire to evaluate stress levels. Analysis: Logistic regression was performed to identify predictors of food security and perceived stress. Results: Duration of stay in the U.S. was a predictor of food security status, while gender was a predictor of perceived stress. International students in the U.S. for less than a year had a lower chance of being food secure [OR (95% CI) = 0.22 (0.05 - 0.74)]. Female international students had a lower chance of experiencing low perceived stress [OR (95% CI) = 0.07 (0.00 - 0.51)]. Conclusion: In supporting international students, targeted nutrition and stress management interventions should be emphasized, particularly for females and those who recently moved to the U.S. [ABSTRACT FROM AUTHOR]

Purpose: While the individual impacts of long-term residence and food insecurity on overweight/obesity are well-documented, their combined effect on immigrants' weight status is less understood. This study examines the interaction between length of residence and food insecurity in predicting overweight/obesity among immigrants and investigates whether this relationship is gender-specific. Design: A national cross-sectional survey. Setting: The 2017-2018 Canadian Community Health Survey. Subjects: Immigrants aged 18 and older (N = 13 680). Measures: All focal variables were self-reported. Analysis: Logistic regression models were employed. Results: Long-term immigrants were more likely to report overweight/obesity than their short-term counterparts (OR = 1.39; P <.001). Moreover, immigrants from food-insecure households were at a higher risk of reporting overweight/obesity (OR = 1.27; P <.05) compared to those from food-secure households. The analysis further revealed that food insecurity exacerbated the detrimental association between length of residence and overweight/obesity in men (OR = 2.63; P <.01) but not in women (OR =.66; P >.05). Conclusion: The findings suggest that long-term immigrant men may be especially susceptible to the compounded chronic stressors of extended residence and food insecurity. Health professionals and policymakers should advocate for psychosocial resources to help mitigate these adverse effects and support the well-being of immigrant populations. [ABSTRACT FROM AUTHOR]

This qualitative critical narrative inquiry study explored the experiences of 19 students within four universities in a single Southern state that used campus food aid resources such as a food pantry. Using Hurtado et al.'s Multicontextual Model for Diverse Learning Environments (MMDLE), this paper sheds light on how participants discussed the campus climate for students experiencing food insecurity within their respective campuses. Findings unpack students' reflections on a lack of awareness and discussion about food insecurity and food aid resources within the campus community, the role that stigmas played in participants' perceptions and use of campus food aid resources, and doubts they had in accessing these resources. Implications for practice and future research are discussed. [ABSTRACT FROM AUTHOR]

Hypertension continues to be a major public health problem affecting almost half of the adults in the US. The intersection of hypertension with food insecurity has not been well-examined specifically among minority populations. We aimed to examine the influence of food insecurity on mortality among adult Hispanics. Data on adult Hispanic (age≥ 20 years) respondents of the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2010 were analyzed. Mortality was assessed by linking these data with the National Death Index through December 31, 2019. Using complex samples Cox regression analysis, the relationship between hypertension, food insecurity, and mortality was assessed. Sociodemographic (age, gender, poverty-income-ratio, marital status, and citizenship status) and health-related characteristics (COPD, diabetes, cardiovascular disease, chronic kidney disease) of the population were included as covariates in the regression analysis to assess mortality risk. The crude hazard ratio (HR) for overall mortality related to hypertension was 4.95 (95% confidence interval [CI] = 4.22–5.82, p <.001). The adjusted HR was elevated, 2.01 (95%CI = 1.50–2.70, p <.001), among individuals with both hypertension and food insecurity. However, among individuals with hypertension and no food insecurity, there was no statistically significant increase in the risk of mortality (HR = 1.09, 95%CI = 0.89–1.34, p > 0.05). In adult Hispanics, food insecurity significantly increases the risk of mortality among those with hypertension compared to food-secure individuals. Clinicians should be sensitized to the need for food security among Hispanics with hypertension to effectively manage hypertension and reduce premature mortality. • The impact of hypertension and cooccurring food insecurity on mortality risk has not been well-examined. • Data on 8163 Hispanic adults was analyzed for this study and 8.8% reported food insecurity and 20.8% had hypertension. • Among individuals with hypertension but no food insecurity, there was no statistically significant increase in the risk of mortality. • Among individuals with both hypertension and food insecurity the risk of mortality was more than two times higher. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to understand if buy-now-pay-later (BNPL) services, a digital type of credit that targets young consumers, acts as a protective or a risk factor for food insecurity among young consumers in Australia. Design/methodology/approach: The study uses survey data from a representative sample of young consumers aged 18–24 from all internal states and territories in Australia. Propensity score matching is used to test two hypotheses: BNPL drives young consumers to food insecurity, and food insecurity leads young consumers to use BNPL. Findings: There is evidence that BNPL use is driving young Australian consumers to experience food insecurity, but there is no evidence of food insecurity driving the use of BNPL services. Practical implications: The evidence of BNPL driving young consumers to experience food insecurity calls for the adoption of practices and stronger regulation to ensure that young users from being overindebted. Originality/value: Although the link with more traditional forms of credit (such as personal loans) and consumer wellbeing has been explored more broadly, this project is the first attempt to have causal evidence of the link between BNPL and food insecurity in a high-income country, to the best of the authors' knowledge. This evidence helps to fill the gap about the protective or risky nature of this type of digital financial product, as experienced by young Australians. [ABSTRACT FROM AUTHOR]

Approximately 13.8 million U.S. households face food insecurity, which severely affects child development, with more than half of these households including children. Research links food insecurity to cognitive deficits and mental health challenges, highlighting the need for thorough understanding and intervention. Although existing studies have explored the association between food insecurity and internalizing symptomatology, less research has examined food insecurity in relation to attention-deficit/hyperactivity disorder (ADHD) symptoms. Further, no studies have explored the connection between food insecurity and cognitive disengagement syndrome (CDS) symptoms, closely related to ADHD symptoms. Despite extant research linking CDS to environmental factors, empirical attention to its potential association with food insecurity is notably lacking. Additionally, adolescents, almost twice as likely as younger children to experience household food insecurity, are likely more aware and respond differently to challenges during this developmental period. Accordingly, this study investigated the unique associations of parent-, teacher-, and youth self-reported ADHD dimensions and CDS symptoms in relation to parent-reported food insecurity in early adolescents (N = 136, ages 10–12). Controlling for age, sex, race, and medication use, no informant's ratings of ADHD symptom dimensions were uniquely related to food insecurity. In contrast, higher parent-, teacher-, and youth self-reported CDS symptoms were uniquely associated with greater food insecurity. This finding was robust to additional control of family income for teacher- and youth self-reported CDS symptoms. These findings highlight the complex link between food insecurity and mental health, suggest a connection with CDS symptoms, and stress the need to address food insecurity as a public health priority, especially in early adolescence. [ABSTRACT FROM AUTHOR]

This study examined the association between sleep duration and food insecurity among Canadian adults (n = 8,406). We employed logistic regression models to estimate the association between sleep duration and food insecurity status among adults in Manitoba and Saskatchewan. The prevalence of short sleep (<7 hours), long sleep (>9 hours), and recommended sleep (7–9 hours) are 42%, 5%, and 53%, respectively. Short sleep duration (RRR = 1.40, p <.05) was found to be significantly associated with food insecurity after controlling for relevant sociodemographic, economic, lifestyle, and health-related variables. We conclude with a discussion of the findings in the context of implications and recommendations for policy and future research. [ABSTRACT FROM AUTHOR]

The purpose of this scoping review was to assess the physical, social, and mental health factors associated with food insecurity among refugee children in the MENA region. The Arksey and O'Malley (2005) York methodology guided the review. Included studies emphasized physical, social, and mental health factors associated with food insecurity among MENA refugee children. Twelve limitation categories were identified based on recurrence across studies. Major themes were highlighted from lessons learned across studies. Results may contribute to an understanding of limitations to consider when developing food relief interventions among children's refugees in the MENA region. [ABSTRACT FROM AUTHOR]

We examined discordant food security (FS) status classification between the USDA 10-item and six-item FS Survey Modules (FSSMs) among students at a U.S. university. A random sample reflecting the University's sociodemographic composition was recruited by e-mail in 2020. Respondents (N = 2653) completed the FSSMs. FS status (binary: food secure/insecure; four-category: high/marginal/low/very low) was determined using the 10-item and six-item FSSMs. Seventy (2.6%) students were discordantly classified on binary FS and 238 (9%) on four-category FS. American Indian students, international students, Supplemental Nutrition Assistance Program participants, and students with child dependents or housing insecurity had higher odds of discordant classification. [ABSTRACT FROM AUTHOR]

We analyzed county food pantry use data for 2019 and 2020 (n = 1,169,568 pantry visits) to explore differences in pantry use among four types of households determined by the presence of seniors and/or children. Our results show that household composition had a significant (p <.001) impact on food pantry utilization, with multi-generational families with children's pantry reliance per year higher than any other group in both 2019 and 2020. The constant high pantry usage of these families suggests chronic food need among families with seniors and children including grandfamilies and highlights the need for tailored interventions. [ABSTRACT FROM AUTHOR]

This study examines the relationship between residential mobility and self-rated health among Indigenous adults aged 19–24, exploring whether food insecurity acts as a mediator or moderator in this relationship. Data were collected from the 2017 Aboriginal Peoples Survey, a nationally representative survey administered by Statistics Canada (N = 4,028). Logistic regression analysis revealed that food insecurity fully mediated the negative effects of residential mobility on self-rated general and mental health. Furthermore, food insecurity amplified the negative impacts of residential mobility on both health outcomes. These results underscore the importance of implementing culturally specific interventions to address food insecurity among young Indigenous adults. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic worsened food insecurity worldwide. The aim of this study was to examine the impact of the pandemic on perceived food insecurity among households in rural Esmeraldas, Ecuador. We conducted a cross-sectional survey to characterize pandemic impacts on household livelihoods and food insecurity in five communities. Fifteen months after the pandemic began, food insecurity was reported in almost half of all households. Residents of the least accessible community reported the greatest disruptions in food availability, while residents of more accessible communities reported greater disruption to livelihoods. These data suggests that transportation restrictions differentially impacted the least accessible rural communities. [ABSTRACT FROM AUTHOR]

Traditional food pantries distribute identical bags of food to all neighbors. Choice pantries allow neighbors to select their food. The study intervention included monthly calls to build the capacity of pantries to offer more choice. Goals were to explore barriers, facilitators, and impact of offering choice. Ninety pantries from 26 food banks completed surveys, and 16 pantries participated in qualitative interviews. Food pantries of all types were able to offer choice, and pantries significantly increased choice between July 2021 and February 2022. Of pantries that increased choice, 79% said overall operations improved. Results can encourage additional pantries to offer choice. [ABSTRACT FROM AUTHOR]

The purpose of this qualitative descriptive study was to understand the experiences of food insecure college students during the Covid-19 pandemic. Twenty-four students who self-identified as food insecure were recruited from social media and email listservs. Individual Zoom interviews were conducted. The recordings of interviews were transcribed and analyzed. Three major themes emerged: (1) access to more resources; (2) multiple losses; and (3) "college kids need help." [ABSTRACT FROM AUTHOR]

During April and May 2022, four schools in rural southern Illinois hosted food drives to stock pantry shelves for summer. To test the efficacy of a brief intervention encouraging healthier donations, a random sample of foods from each drive was evaluated for nutrition quality. The Supporting Wellness at Pantries (SWAP) stoplight nutrition system was used to evaluate saturated fat, sodium, and sugar content of 1,157 foods. Results were positive with 35.2% of foods being categorized as green (choose often), 42% yellow (choose sometimes), and 22.7% red (choose rarely). No significant differences existed between drives. Providing shopping lists increases healthier donations. [ABSTRACT FROM AUTHOR]

To identify relationships between food choice motivators (FCM) and food security in university students, a questionnaire assessing food security and FCM was distributed in Winter 2020 to 10,000 university students (1,535 responses; 1,408 included in demographic analysis, 1,189 included in other analyses). Chi-square test of independence, logistic and linear regressions assessed associations among food security, FCM, and demographics. Exploratory factor analysis (EFA) determined factors of FCM. Kendall's tau assessed association between FCM and food insecurity. EFA identified three factors of FCM: (1) Hedonics, (2) Constraints, and (3) Nutrition Knowledge. Food insecurity was associated with Hedonics, Constraints, and other demographics. [ABSTRACT FROM AUTHOR]

Food insecurity in college students, worsened during the COVID pandemic. However, students are often hesitant to access food assistance The purpose of this study was to explore students' perceptions of barriers to the use of food assistance. In 2021, students (n = 13) were recruited from a Kentucky college. Virtual interviews were conducted. Further research is needed to explore other barriers to use of food assistance. Research is needed to evaluate interventions aimed at decreasing the stigma of food assistance in college students. [ABSTRACT FROM AUTHOR]

Food insecurity is a major social determinant of health (SDH). However, further research is needed on the associations between SDH and diet among individuals living in urban food deserts. We designed a pilot study to examine the associations between diet and seven measures of SDH. Forty-five participants were enrolled in the study and were scheduled for an in-person or telephone interview. Food insecurity was significantly associated with greater intakes of fast food and refined grains. Employment was significantly associated with higher intake of alcohol. Findings from this pilot study confirm the importance of examining SDH in relation to diet. [ABSTRACT FROM AUTHOR]

Food insecurity and transportation inequity are known to disproportionately impact the welfare of marginalized communities. Our study analyzed census data in Harris County, Texas comparing food insecurity rate and components of the Quality Affordable Transportation Index to explore their relationship. Mapping, geographically weighted regression (GWR), and linear regression methods were used to identify relationships between food insecurity and transportation. Poor walkability is more commonly associated with food insecure areas than is poor public transit in Harris County. GWR helped to identify an area of strong correlation between walkability and food insecurity in southwestern Harris County that may benefit from further study. [ABSTRACT FROM AUTHOR]

Household food insecurity in the rural township of Kaitaia is evident. This study aimed to explore strategies used by Māori (indigenous New Zealanders) mothers to meet food access needs for their whānau (family). In-depth personal interviews were undertaken with 20 Māori mothers. Three themes emerged from thematic analysis using NVivo: ensuring the whānau is fed; accessing food from multiple avenues is a time-consuming journey and the need to cope with the unexpected and unplanned. Access to food was further facilitated by strong connections to whānau, community groups and government agencies which are pivotal to navigate multiple avenues for food access. [ABSTRACT FROM AUTHOR]