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Residents of the Lower Mississippi Delta of Arkansas, Louisiana, and Mississippi are at risk for food insecurity since a high proportion of the population live in households with incomes below the poverty level and have reduced access to food and decreased availability of a variety of foods. However, the magnitude of the problem is unknown because presently only nationwide and state estimates of food insecurity are available. Purpose: This study was conducted by the Lower Mississippi Delta Nutrition Intervention Research Consortium to determine the prevalence of household food insecurity, identify high-risk subgroups in the Lower Delta, and compare to national data. Methods: A 2-stage stratified cluster sample representative of the population in 36 counties in the Lower Delta was selected using list-assisted random digit dialing telephone methodology. A cross-sectional telephone survey of 1662 households was conducted in 18 of the 36 counties using the US Food Security Survey Module. Findings: Twenty-one percent of Lower Delta households were food insecure, double the 2000 nationwide rate of 10.5%. Within the Lower Delta, groups with the highest rates of food insecurity were households with income below $15,000, black households, and households with children. The prevalence of hunger in Delta households with white children was 3.2% and in households with black children was 11.0%, compared to nationwide estimates of 0.3% and 1.6%. Conclusions: The Lower Mississippi Delta is characterized by a high prevalence of food insecurity and hunger. Future efforts to identify the household and community determinants of food insecurity to reduce its high prevalence are indicated.

Objective To determine if measures of diet quality differ between food insecure and food secure adults in a rural high-risk population. Design Random digit dialing telephone survey of a cross-section of the population designed to collect data on food intake, household demographics, and food security status. Setting A representative sample of adults who live in 36 counties in the Lower Mississippi Delta region of Arkansas, Louisiana, and Mississippi. Subjects One thousand six hundred seven adults, both white and African American. Main outcome measures Food security status and diet quality, as defined by adherence to the Healthy Eating Index and Dietary Reference Intakes by determinations from self-reported food intake (1 day intake). Statistical analyses Regression analysis, t tests, Wald statistic, and beta tests were employed. Results Food secure adults scored higher on Healthy Eating Index than food insecure adults (P=0.0001), but the regression model showed no differences when multiple factors were included. Food secure individuals consistently achieved higher percentages of the Dietary Reference Intakes (specifically Estimated Average Requirements and Adequate Intakes) than food insecure individuals, with the greatest differences seen for vitamin A (P<0.0001), copper (P=0.0009), and zinc (P=0.0022) and very little difference for vitamins C (P=0.68) and E (P=0.32). Both populations consumed diets extremely low in fiber. Conclusions Food insecurity is associated with lower quality diets in this population. It is acknowledged that serious limitations are associated with the use of one 24-hour recall and for comparison between food intake and assessment of food security. These findings still suggest a pressing need for nutrition interventions to improve dietary intake in these at-risk impoverished individuals.

Objective: The purpose of this study was to identify personal, behavioral, and environmental factors influencing fruit and vegetable consumption among 10- to 13-year-old low-income black American youth in the lower Mississippi Delta region. Social Cognitive Theory, along with other theoretical constructs, guided focus group questions and analysis. Design: A qualitative study using focus group methodology. Setting: Enrichment program of a sports summer camp for low-income youth. Participants: Forty-two adolescents (21 female, 21 male) participated in 6 focus groups. Main Outcome Measures: Personal, behavioral, and environmental influences on fruit and vegetable consumption. Analysis: Content analysis methods were used by 3 independent reviewers to identify themes within the focus group transcripts. Themes were summarized and then categorized into the 3 domains of Social Cognitive Theory. Results: The major themes were taste, availability, extended family influence, visual proof of the benefits of fruit and vegetable consumption, and the need for gender-specific behavioral skills. Conclusions and Implications: This formative research will aid in the development of a culturally relevant nutrition intervention for low-income black American adolescents in the lower Mississippi Delta region. The results indicate that this group is more likely to respond to interventions that use role models who can provide proof that fruit and vegetable consumption is related to improved health. KEY WORDS: fruits and vegetables, low-income adolescents, Social Cognitive Theory, focus groups, black American

The prevalence of household food security, which reflects adequacy and stability of the food supply, has been measured periodically in the United States and occasionally in high-risk groups or specific regions. Despite a plausible biological mechanism to suggest negative health outcomes of food insecurity, this relation has not been adequately evaluated. This study was conducted in the Lower Mississippi Delta region to examine the association between household food insecurity and self-reported health status in adults. A two-stage stratified cluster sample representative of the population in 36 counties in the Delta region of Arkansas, Louisiana, and Mississippi was selected using list-assisted random digit dialing telephone methodology. After households were selected and screened, a randomly selected adult was interviewed within each sampled household. Data were collected to measure food security status and self-reported mental, physical, and general health status, using the U.S. Food Security Survey Module and the Short Form 12-item Health Survey (SF-12). Data were reported on a sample of 1488 households. Adults in food-insecure households were significantly more likely to rate their health as poor/fair and scored significantly lower on the physical and mental health scales of the SF-12. In regression models controlling for income, gender, and ethnicity, the interaction between food insecurity status and race was a significant predictor of fair/poor health and lower scores on physical and mental health. Household food insecurity is associated with poorer self-reported health status of adults in this rural, high-risk sample in the Lower Mississippi Delta. KEY WORDS: * community nutrition * food insecurity * health status

To assess the possibility of ethnic differences in mineral metabolism in prepubertal children, we compared measures of calcium metabolism in 7- and 8-y-old Mexican-American (MA) and non-Hispanic Caucasian (CAU) girls (n = 38) living in southeastern Texas. We found similar fractional calcium absorption, urinary calcium excretion, calcium kinetic values and total-body bone mineral content in the MA and CAU girls. In contrast, parathyroid hormone (PTH) concentrations were greater in MA girls (4.01 [+ or -] 0.47 vs. 1.96 [+ or -] 0.50 pmol/L, P = 0.005) than in CAU girls. Serum 25-hydroxyvitamin D concentrations were lower in MA girls (68.9 [+ or -] 7.7 vs. 109.4 [+ or -] 8.4 nmol/L, P = 0.001) than in CAU girls, but 1,25-dihydroxyvitamin D concentrations did not differ between groups. Seasonal variability was seen for 25-hydroxyvitamin D concentrations in girls of both ethnic groups, but values in all of the girls were >30 nmol/L (12 ng/mL). We conclude the following: 1) greater PTH levels in MA girls than CAU girls are present without evidence of vitamin D deficiency; and 2) differences in 25-hydroxyvitamin D and PTH concentrations between MA and CAU girls do not have a large effect on calcium absorption, excretion or bone calcium kinetics. These data do not provide evidence for adjusting dietary recommendations for mineral or vitamin D intake by MA girls. KEY WORDS: * human nutrition * calcium metabolism * stable isotopes * bone mineralization * puberty

CONTEXT. The prevalence of childhood overweight status is increasing. Some have suggested that childhood overweight is associated with food insecurity, defined as limited or uncertain access to enough nutritious food. OBJECTIVES. The purpose of this work was to assess the association of household and child food insecurity with childhood overweight status. METHODS. The National Health and Nutrition Examination Survey 1999-2002 uses a stratified multistaged probability sample and collects a broad array of data from a nationally representative sample of US citizens. All children 3 to 17 years old in this sample are included in these analyses. We measured BMI categorized as at risk for overweight or greater ([greater than or equal to] 85%) or overweight ([greater than or equal to] 95%) and household and child food security/insecurity using the US Food Security Scale. RESULTS. When compared with children from food-secure households, children from food-insecure households were more likely to demonstrate significant associations with being at risk for overweight or greater in the following demographic categories: 12 to 17 years, girls, white, and in households with income 4 times the federal poverty level. Household food insecurity is associated with child overweight status in children aged 12 to 17, girls, and children who live in households with incomes >4 times the federal poverty level. Child food insecurity demonstrated the same associations with being at risk for overweight or greater, as did household food insecurity, but associations were also seen in 3- to 5-year-old children, boys, and Mexican American children. Child food insecurity is significantly associated with child overweight status for children aged 12 to 17, girls, white children, and children in families with income [less than or equal to] 100% poverty level. Controlling for ethnicity, gender, age, and family poverty index level, childhood food insecurity is associated with a child being at risk for overweight status or greater, but not overweight status. CONCLUSIONS. Household and child food insecurity are associated with being at risk for overweight and overweight status among many demographic categories of children. Child food insecurity is independently associated with being at risk for overweight status or greater while controlling for important demographic variables. Future longitudinal research is required to determine whether food insecurity is causally related to child overweight status. KEY WORDS. food insecurity, child health status, overweight children., URL: www.pediatrics.org/cgi/doi/10.1542/peds2006-0097 Patrick H. Casey, MD, Pippa M. Simpson, PhD, Jeffrey M. Gossett, MS, Margaret L. Bogle, PhD, Catherine M. Champagne, PhD, Carol Connell, PhD, David Harsha, PhD, Beverly McCabe-Sellers, [...]

Context. Studies examining the association between food insecurity and obesity in adults have produced conflicting results, and information is limited on the relationship between food insecurity and adult chronic health conditions, particularly in a high-risk population. Objective. To examine the association between household food insecurity and self-reported weight status and chronic disease in the Lower Mississippi Delta. Design. A two-stage stratified cluster sample representative of the population in 36 counties in the Lower Delta. Data were collected in a cross-sectional telephone survey using list assisted random digit dialing telephone methodology. Setting and Participants. A randomly selected sample of 1,457 adults from a free-living population. Main Outcome Measures. US Food Security Survey Module, self-reported height and weight status (obesity = body mass index > 30 kg/m²), and self-reported hypertension, high cholesterol, diabetes, heart disease, stroke, and a marker for metabolic syndrome. Results. In food-insecure adults, 42.3% were obese, a significantly higher rate than food secure adults (33.2%). After controlling for demographic variables, food insecurity was not independently associated with obesity. Income and the interaction between race and gender were significant predictors of obesity. Food insecure adults were significantly more likely to report hypertension (45.1% vs. 29.5%) diabetes (15.0% vs. 9.3%), heart disease (13.5% vs. 6.8%) and metabolic syndrome (10.1% vs. 4.4%). After controlling for demographic variables, food insecurity was associated with high cholesterol (Odds Ratio [OR] 1.65; 95% Confidence Interval [CI], 1.0 to 2.7), heart disease (OR 2.7: 95% CI, 1.5 to 4.8), and metabolic syndrome (OR 2.8; 95% CI, 1.4 to 5.5). Conclusions. The relationship between food insecurity and obesity in a high-risk population, may be due to income and demographic variables. Individuals in a rural high-risk population with high cholesterol, heart disease, and metabolic syndrome have a high likelihood of being food-insecure. Nutritional interventions targeting high-risk populations should address food insecurity. [ABSTRACT FROM AUTHOR]

Between-individual variation (BIV) and thy-to-day variation (DDV) of total caloric and human milk intakes were examined in 17 infants. Nine were studied at months 5 and 6; 8 at months 6 and 7. All 17 were exclusively breast-fed for 5 full mo after which solid foods were added to the diet. Each infant was studied for five consecutive 24-h periods during which serial measurements were made of milk intake (test weighing) and solid food intake (pre- and postfeeding jar weighing). Total daily caloric intakes (kcal/day) were (mean ± SD) 492 ± 57, 547 ± 70, and 567±98 at months 5, 6, and 7, respectively. Estimates of caloric intakes (kcal/kg/day) adjusted for body weight were 65.9 ± 6.7, 72.6 ± 11.2, and 70.9 ± 13.0 at months 5, 6, and 7, respectively. Milk intakes (g/day) were 735 ± 85, 640 ± 106, and 562 ± 214 at months 5, 6, and 7, respectively. BIV of milk intake increased after the introduction of solid foods. DDV (expressed as coefficient of variation) of caloric intake was nearly constant at each monthly observation and BIV increased from 8.8 at month 5 to 14.6 at month 7. The numbers of 24-h periods and subjects required for estimates of known precision of caloric and milk intakes of older breast-fed infants can be determined from these estimates of variance. [ABSTRACT FROM AUTHOR]

Cardiovascular heart disease is a major health problem in the United States. Elevated blood cholesterol has been shown to significantly increase the risk of cardiovascular heart disease. The National Cholesterol Educational Program (NCEP) Step I diet, which restricts fat and cholesterol intakes, is usually recommended as the initial treatment to lower blood cholesterol. Soy protein has been shown to be hypocholesterolemic, particularly in hypercholesterolemic subjects. However, the hypocholesterolemic effect of soy protein in subjects with a blood total cholesterol concentration < 5.17 mmol/L is not clear. To determine whether soy protein could enhance the hypocholesterolemic effect of the NCEP Step I diet, 13 normocholesterolemic and 13 hypercholesterolemic men aged 20–50 y were enrolled in a randomized, 2-part, crossover study. Subjects were fed either an NCEP Step I soy-protein diet or an NCEP Step I animal protein diet for 5 wk. After a washout period of 10–15 wk, the subjects were fed the alternate diet for 5 wk. The hypocholesterolemic effect of soy protein was found to be independent of age, body weight, pretreatment plasma lipid concentrations, and sequence of dietary treatment. Regardless of plasma lipid status, the soy-protein diet was associated with a statistically significant decrease in the plasma concentrations of LDL cholesterol (P = 0.029) as well as the in the ratio of plasma LDL cholesterol to HDL cholesterol (P = 0.005). Our results indicate that soy protein enhances the hypocholesterolemic effect of the NCEP Step I diet in both normocholesterolemic and hypercholesterolemic men. [ABSTRACT FROM AUTHOR]