Validation of the Radimer/Cornell food insecurity measure in rural Kilimanjaro, Tanzania

OBJECTIVE: The objective of the present study was to assess the construct validity, criterion-related validity and internal consistency of the Radimer/Cornell food insecurity measure for use in rural Tanzania. DESIGN: A cross-sectional community-based survey was conducted from March to May 2005. Key adaptations to the nine-item Radimer/Cornell items included translation to Swahili, replacing the term 'balanced diet' with 'full meal' and constructing the items as questions rather than statements. Factor analysis and Cronbach's alpha were used to assess validity and reliability, respectively. SETTING: Rural Kilimanjaro, Tanzania. SUBJECTS: Analysis was restricted to data from 530 women aged 15-44 years who had children under 5 years old. RESULTS: Principal component factor analysis revealed a two-factor solution: (1) altered eating pattern at household level and (2) altered eating pattern at child level. The two factors accounted for 66.2% of the total variance. The subscales developed had good reliability. Internal consistency of the scales was 0.853 and 0.784 for food insecurity at household level and food insecurity at child level, respectively. Only 14.0% of the women reported to be food-secure and 86.0% reported some kind of food insecurity. The Radimer/Cornell food insecurity measure showed significant associations with selected sociodemographic factors in the expected directions. There was also an association with the NHANES III (Third National Health and Nutrition Examination Survey) and CCHIP (Community Childhood Hunger Identification Project) indicators. CONCLUSION: Our findings suggest that the adapted Radimer/Cornell measure may have some utility in assessing food insecurity in settings like rural Tanzania.     

Food insecurity, weight control practices and body mass index in adolescents

OBJECTIVE: We investigated whether experienced food insecurity was associated with weight control behaviour of adolescents. DESIGN: A national survey of 16-year-old students with the six-item food security scale, questions concerning intentions of trying to change weight, physical activity patterns, and measurement of height and weight. SETTING: Representative sample of 29 schools in Trinidad, West Indies. SUBJECTS: Data analysed for 1903 subjects including 1484 who were food-secure and 419 who were food-insecure. RESULTS: In the whole sample, food security status did not vary by body mass index (BMI) category. 'Trying to gain weight' and 'spending most free time in activities involving little physical effort' were each associated with lower BMI. 'Trying to gain weight' was more frequent in food-insecure subjects (135, 32%) than in food-secure subjects (369, 25%, P = 0.012). After adjustment for BMI, age, sex, ethnicity and socio-economic variables, the adjusted odds ratio (OR) of 'trying to gain weight' for food-insecure subjects was 1.39 (95% confidence interval (CI) 1.07-1.82, P = 0.014). Food-insecure subjects (197, 47%) were more likely than food-secure subjects (575, 39%) to report that most of their free time was spent doing things that involved little physical effort (P = 0.003). This association was not explained by adjustment for BMI, age, sex and ethnicity (OR = 1.41, 95% CI 1.13-1.76, P = 0.002) or additional socio-economic variables (OR = 1.27, 95% CI 1.02-1.57, P = 0.033). CONCLUSIONS: Adolescents who experience food insecurity are more likely to intend to gain weight but engage in less physical activity than food-secure subjects with the same BMI.     

Acculturation, economics and food insecurity among refugees resettled in the USA: a case study of West African refugees

OBJECTIVES: To assess the occurrence and severity of food insecurity, and examine associations between food insecurity and measures of socio-economic status and indicators of acculturation. DESIGN: Structured interviews among a non-probability sample of West African refugees at baseline and 6 months' follow-up.Setting Mid-sized city in north-eastern USA. SUBJECTS: One hundred and one caregivers with children under the age of 5 years and who have been living the USA for fewer than 4 years. RESULTS: Food insecurity was indicated in approximately half of households (53%). The occurrence of food insecurity was associated with measures of socio-economic status such as income, employment status and participation in the Food Stamp Program (P < 0.05). Measures of acculturation such as difficulty in the shopping environment and language difficulty were also associated with the occurrence and severity of food insecurity, as was time lived in the USA (P < 0.05). Among households who had been in the USA for 1 year or less, food insecurity was indicated in 73%, whereas among households who had been in the USA for at least 3 years food insecurity was indicted in 33%. CONCLUSIONS: Refugees are a potentially vulnerable group and our results echo others in suggesting a need for more thorough monitoring of the health and well-being of recently resettled refugees. These results also suggest that reliance on employment as the sole indicator of success in the resettlement process may be too narrow an indicator. Future research should focus on a wider range of measures of health and well-being.     

Seasonal food insecurity and perceived social support in rural Tanzania

OBJECTIVES: To examine whether the occurrence of seasonal food insecurity was related to ethnicity, household wealth and perceived social support, and to assess whether social support was more efficacious in protecting against food insecurity in wealthier households. Secondary objectives were to assess the association between past food insecurity, current dietary intake and perceived health. DESIGN, SETTING AND SUBJECTS: A sample of 208 randomly selected mothers from two ethnic groups living in the same villages in rural Tanzania participated in a cross-sectional survey. RESULTS: Food insecurity was highly prevalent in this area, particularly among the poorer ethnic group. Half of ethnically Sukuma households fell into the most food-secure category, compared with only 20% of ethnically Pimbwe households. Among both groups, measures of household wealth and social support were strongly associated with food security. Interestingly, social support appeared to be more effective among the wealthier ethnic group/community. Past food insecurity was also related to current indicators of dietary intake and women's self-perceptions of health. CONCLUSION: Greater social support is associated with food security, suggesting that it may protect against the occurrence of seasonal food insecurity. Social support also interacts with wealth to offer greater protection against food insecurity, suggesting that increasing wealth at the community level may influence food insecurity through both direct and indirect means. Seasonal food insecurity also appears to have lasting effects that likely create and reinforce poverty.     

Eating rough: food sources and acquisition practices of homeless young people in Adelaide, South Australia

OBJECTIVE: The aim of this study was to determine the food sources and acquisition practices used by homeless youth in Adelaide. This work is part of a larger study that aimed to examine the extent and nature of food insecurity among homeless youth. DESIGN: Cross-sectional design involving quantitative and qualitative methods. SETTING: Four health and welfare inner-city agencies serving homeless youth in Adelaide, South Australia. SUBJECTS: A sample of 150 homeless youth aged between 15 and 24 years recruited from these agencies. Fifteen were selected via snowball sampling for interview. RESULTS: Use of welfare food sources was high (63%). Food from welfare agencies was supplemented by unorthodox food acquisition methods such as theft (65%), begging for money for food (61%), begging for food items (44%) and asking for help from friends and relatives (34%). Reasons given for non-usage of welfare food services included affordability, access, being too busy, shame or embarrassment. CONCLUSIONS: Food insecurity is a salient issue for some homeless youth in Adelaide. Clarifying food acquisition practices of food-insecure homeless youth is essential for rational planning and improvement of food-related services to meet their needs. Such an understanding also underpins the development of broader public policy responses that improve individual and household skills and resources to acquire food and ensure food security. Nutrition professionals, welfare professionals and policy-makers need to work sensitively with welfare food agencies and others to improve food access and food security for homeless youth.     

Does interview mode matter for food security measurement? Telephone versus in-person interviews in the Current Population Survey Food Security Supplement

OBJECTIVE: To assess whether interview mode (telephone vs. in-person) affects the results of surveys that measure food security. DESIGN: Responses given by households interviewed by telephone and in-person in recent US Current Population Survey Food Security Supplements (CPS-FSS) were compared. Statistical methods based on the Rasch measurement model were used to assess whether response patterns differed between the two interview modes. Multivariate logistic regression analysis was then used to gauge the effect of interview mode on the measured household prevalence rates of food insecurity and very low food security while controlling for income, employment, household structure, and other household characteristics that affect food security. RESULTS: Response patterns to the indicators that comprise the food security scale did not differ substantially between interview modes. Prevalence rates of food insecurity and very low food security estimated from the two interview modes differed by only small proportions after accounting for differences in the socio-economic characteristics of households. CONCLUSIONS: Findings suggest that effects of interview mode on food security measurement in the CPS-FSS are small, or at most modest. Prevalence estimates may be biased upwards somewhat for households interviewed in-person compared with those interviewed by telephone. The extent to which these results can be generalised may depend, to some extent, on survey characteristics other than interview mode, such as surveyor name recognition and respondents' trust and confidence in the surveyor.     

Who is food-insecure in California? Findings from the California Women's Health Survey, 2004

OBJECTIVE: To identify factors associated with food insecurity in California women. DESIGN: The California Women's Health Survey is an ongoing annual telephone survey that collects data about health-related attitudes and behaviours from a randomly selected sample of women. Food insecurity of the women was measured by a 6-item subset of the Food Security Module. Statistical procedures included chi-square tests, t-tests, logistic regression analysis and analysis of covariance. SETTING: California, USA. SUBJECTS: Four thousand and thirty-seven women (18 years or older). RESULTS: Prevalence of food insecurity was 25.7%. After controlling for income, factors associated with greater food insecurity were Hispanic or Black race/ethnicity; less than a 12th grade education; being unmarried; less than 55 years old; being Spanish-speaking; having spent less than half of one's life in the USA; sadness/depression; feeling overwhelmed; poor physical/mental health interfering with activities; and fair to poor general health. Among Food Stamp Program (FSP) participants, 71% were food-insecure. Among FSP-eligible women who had not applied for the programme, the prevalence of food insecurity was lower among women responding that they did not need food stamps than in women giving other reasons for not applying (23.9% vs. 66.9%, P < 0.001). Factors associated with food insecurity in FSP recipients included being unable to make food stamps last for 30 days, feeling overwhelmed, and having a birthplace in Mexico or Central America. CONCLUSIONS: Along with several socio-economic variables, poor physical and mental health is associated with food insecurity. Whether food insecurity is a cause or effect of poor health remains in question.     

Food insecurity among homeless and runaway adolescents

OBJECTIVE: The purpose of this study was to investigate the prevalence of food insecurity and factors related to it among homeless and runaway adolescents. DESIGN: Computer-assisted personal interviews were conducted with homeless and runaway adolescents directly on the streets and in shelters. SETTING: Interviews were conducted in eight Midwest cities: Des Moines, Cedar Rapids, Iowa City, Kansas City, Lincoln, Omaha, St. Louis and Wichita. SUBJECTS: The subjects were 428 (187 males; 241 females) homeless and runaway adolescents aged 16-19 years. Average age of the adolescents was 17.4 (standard deviation 1.05) years. RESULTS: About one-third of the adolescents had experienced food insecurity in the past 30 days. Factors associated with food insecurity were age of adolescent, a history of caretaker neglect and abuse, having ever spent time directly on the street, a small post-runaway social network, and engaging in deviant and non-deviant street food-acquisition strategies. CONCLUSIONS: Based on these findings, our conservative estimate is that nationally more than 165,000 homeless and runaway adolescents experienced food insecurity in the past 30 days. These adolescents are largely hidden from public notice and they are usually missed in studies that address national hunger.     

Identifying 'unhealthy' food advertising on television: a case study applying the UK Nutrient Profile model

OBJECTIVES: To evaluate the feasibility of the UK Nutrient Profile (NP) model for identifying 'unhealthy' food advertisements using a case study of New Zealand television advertisements. DESIGN: Four weeks of weekday television from 15.30 hours to 18.30 hours was videotaped from a state-owned (free-to-air) television channel popular with children. Food advertisements were identified and their nutritional information collected in accordance with the requirements of the NP model. Nutrient information was obtained from a variety of sources including food labels, company websites and a national nutritional database. RESULTS: From the 60 h sample of weekday afternoon television, there were 1893 advertisements, of which 483 were for food products or retailers. After applying the NP model, 66 % of these were classified as advertising high-fat, high-salt and high-sugar (HFSS) foods; 28 % were classified as advertising non-HFSS foods; and the remaining 2 % were unclassifiable. More than half (53 %) of the HFSS food advertisements were for 'mixed meal' items promoted by major fast-food franchises. The advertising of non-HFSS food was sparse, covering a narrow range of food groups, with no advertisements for fresh fruit or vegetables. CONCLUSIONS: Despite the NP model having some design limitations in classifying real-world televised food advertisements, it was easily applied to this sample and could clearly identify HFSS products. Policy makers who do not wish to completely restrict food advertising to children outright should consider using this NP model for regulating food advertising.     

基于缺口率模型的区域粮食安全风险评估

深入分析各区域的粮食供需趋势对于保障中国未来的粮食安全至关重要。该文首先分析了影响中国粮食供需安全的风险源,提出了粮食主产区、粮食主销区和产销平衡区的粮食缺口率风险评估模型并划分了相应的风险等级,然后以洞庭湖区为例进行了实证分析。结果表明:自然灾害是影响洞庭湖区粮食供给安全的最主要因素,人口增长则是影响该区域粮食安全的普遍因素;对于大多数的县/市,资源和投入要素对未来的粮食供给将产生积极的影响。当自然灾害为一般情景或乐观情景时,洞庭湖区的粮食安全状况较为乐观;当自然灾害为悲观情景时,湖区部分县/市的粮食安全形势非常严峻。但就湖区整体而言,通过湖区内部调剂即可以满足高风险县/市的粮食需求。研究结果可为相关部门的政策制定提供客观依据,为粮食安全的风险预警和防范提供参考。     

Prevalence and predictors of food insecurity among low-income households in Los Angeles County

OBJECTIVES: To assess the prevalence and identify the predictors of food insecurity among households in Los Angeles County with incomes below 300% of the federal poverty level. METHODS: The Six-Item Short Form of the US Department of Agriculture's Household Food Security Scale was used as part of a 1999 county-wide, population-based, telephone survey. RESULTS: The prevalence of food insecurity was 24.4% and was inversely associated with household income. Other independent predictors of food insecurity included the presence of children in the household (odds ratio (OR) 1.7, 95% confidence interval (CI) 1.2-2.3) and a history of homelessness in the past five years (OR 5.6, 95% CI 3.4-9.4). CONCLUSION: Food insecurity is a significant public health problem among low-income households in Los Angeles County. Food assistance programmes should focus efforts on households living in and near poverty, those with children, and those with a history of homelessness.     

Food insecurity in community-dwelling older Australians

OBJECTIVE: To identify the extent of food insecurity (defined as running out of food in the last 12 months and being unable to afford to buy more) amongst older Australians, and the characteristics of those who experience this condition. DESIGN: Cross-sectional population survey. SETTING AND SUBJECTS: Respondents (n = 8,881) were community-dwelling older people (65 years and older) living independently in New South Wales, Australia, randomly sampled to participate in a computer-assisted telephone interview conducted during 1999-2000. The response rate was 71%. Responses to a food insecurity questionnaire item were collected along with sociodemographic information, living arrangements, lifestyle and self-rated health. Univariate analyses and logistic regression modelling of factors for reporting food insecurity were conducted. RESULTS: Approximately one in 50 older people reported experiencing food insecurity in the previous 12 months attributable to inadequate finances. The analyses revealed that those at risk can be identified as more likely to report poorer health, limited financial resources, not owning their own home and living alone. Gender and age differences were also evident. CONCLUSION: While only a minority of older Australians reported experiencing food insecurity attributable to inadequate finances, such people are at higher risk of malnutrition and associated morbidity. Food insecurity is an important public health and equity issue in older people that can be addressed through implementing appropriate income and social support policies.     

Bringing home the right to food in Canada: challenges and possibilities for achieving food security

We offer a critique of Canada's approach to domestic food security with respect to international agreements, justiciability and case law, the breakdown of the public safety net, the institutionalisation of charitable approaches to food insecurity, and the need for 'joined-up' food and nutrition policies. We examined Canada's commitments to the right to food, as well as Canadian policies, case law and social trends, in order to assess Canada's performance with respect to the human right to food. We found that while Canada has been a leader in signing international human rights agreements, including those relating to the right to food, domestic action has lagged and food insecurity increased. We provide recommendations for policy changes that could deal with complex issues of state accountability, social safety nets and vulnerable populations, and joined-up policy frameworks that could help realise the right to adequate food in Canada and other developed nations.     

School food in Mexican children

OBJECTIVE: To establish the school eating habits of Mexican children, who are prone to obesity and later to high rates of adult chronic diseases. DESIGN: Questionnaires for students and parents with staff questionnaires and interviews. SETTING: Randomly sampled schools in a socio-economically representative district of Mexico City. SUBJECTS: Subjects were 1504 adolescents aged 10-19 years attending schools in Mexico City, 27 teachers and seven headmasters, sampled from both public and private schools and from the full range of socio-economic groups. RESULTS: Foods brought from home were of a higher nutritional quality than those purchased at school, where purchases were dominated by crisps, soft drinks and other items with high energy density. Girls were more inclined to purchase inappropriately; those from poorer homes purchased less. Private-school students irrespective of socio-economic grade brought more food from home and purchased more expensive food at school. School policies allowed food and drink vendors to market any products within the schools, which benefited financially from these activities. CONCLUSIONS: Current school food policies are conducive to amplifying the current epidemic of obesity and related adult chronic diseases, and need to change.     

Ethnic differences in body mass index and associated factors of adolescents from minorities in Oslo, Norway: a cross-sectional study

OBJECTIVES: To examine ethnic differences in body mass index (BMI), food habits and physical activity, and determine the factors contributing to differences in BMI. DESIGN AND METHOD: In 2000-2001, 7343 (response rate 88%) 15- and 16-year-old students, enrolled in lower secondary schools in Oslo, participated in the cross-sectional Oslo Health Study. Of these participants, 1719 were defined as ethnic minorities. RESULTS: Significant gender and ethnic differences in mean BMI were observed. Of the ethnic minority adolescents, 5.8% were underweight (<5th percentile of the US Centers for Disease Control and Prevention (CDC)/National Center for Health Statistics (NCHS) reference distribution) and 9.1% were overweight (>85th percentile of the US CDC/NCHS reference distribution). BMI was not significantly associated with either socio-economic factors or physical activity. Food habits and physical activity differed with ethnicity but not with socio-economic factors. An ordinal regression showed that girls from East Asia (odds ratio (OR) 0.4) and boys from sub-Saharan Africa (OR 0.4) had lower BMI than the Western group. Among girls, higher BMI was associated with less frequent consumption of chocolates and sweets, full-fat milk and breakfast (OR 2.4, 1.7 and 1.7, respectively). Higher BMI, for both boys and girls, was associated with current and past dieting (OR 3.7 and 4.2, respectively). CONCLUSIONS: Adolescent food habits and physical activity varied by gender and ethnicity but not with socio-economic factors. BMI was associated with ethnicity, gender and food habits, but no significant relationship was observed with socio-economic factors or physical activity. Ethnicity, in addition to gender, should be taken into consideration when studying BMI and associated factors among adolescents.     

Poverty and household food security of black South African farm workers: the legacy of social inequalities

OBJECTIVE: To assess socio-economic indicators, nutritional status and living conditions of farm workers and their families, with the purpose to develop research and intervention programmes aimed at enhancing nutritional status and quality of life. DESIGN AND SETTING: Three farm schools in two districts of the North-West Province and farming communities were selected. Anthropometrical measurements, structured face-to-face questionnaires and focus group discussions were carried out in 2002 and 2003 by a multidisciplinary research team. RESULTS: Access to electricity, water and sanitation, as well as monthly food rations or subsidies, vary and depend on farm owners. The majority of adults have education below or up to grade four, farm schools provide only up to grade seven. Distance to farm schools and intra-household issues hamper children's attendance and performance at school. Household food security is compromised due to a lack of financial resources, infrastructure and also household resource allocation. This impacts negatively especially on children, with half of them being underweight, stunted or wasted. Employment is usually linked to men, while most women have access to casual jobs only. Insecurity of residence and the perceived disempowered position towards farm owners add to feelings of hopelessness and stress. CONCLUSIONS AND RECOMMENDATIONS: This study highlights destitute living conditions of farm worker families. Apart from structural and financial constraints, paternalistic structures of the past might also hamper development. Based on these findings, follow-up research projects and in-depth investigations into underlying social issues with regard to nutrition insecurity and livelihoods of farm workers were initiated.     

Fast food for family meals: relationships with parent and adolescent food intake, home food availability and weight status

OBJECTIVE: The purpose of the present study was to examine the prevalence of fast-food purchases for family meals and the associations with sociodemographic variables, dietary intake, home food environment, and weight status in adolescents and their parents. DESIGN: This study is a cross-sectional evaluation of parent interviews and adolescent surveys from Project EAT (Eating Among Teens). SUBJECTS: Subjects included 902 middle-school and high-school adolescents (53% female, 47% male) and their parents (89% female, 11% male). The adolescent population was ethnically diverse: 29% white, 24% black, 21% Asian American, 14% Hispanic and 12% other. RESULTS: Results showed that parents who reported purchasing fast food for family meals at least 3 times per week were significantly more likely than parents who reported purchasing fewer fast-food family meals to report the availability of soda pop and chips in the home. Adolescents in homes with fewer than 3 fast-food family meals per week were significantly more likely than adolescents in homes with more fast-food family meals to report having vegetables and milk served with meals at home. Fast-food purchases for family meals were positively associated with the intake of fast foods and salty snack foods for both parents and adolescents; and weight status among parents. Fast-food purchases for family meals were negatively associated with parental vegetable intake. CONCLUSIONS: Fast-food purchases may be helpful for busy families, but families need to be educated on the effects of fast food for family meals and how to choose healthier, convenient family meals.     

A multilevel study of socio-economic inequalities in food choice behaviour and dietary intake among the Dutch population: the GLOBE study

OBJECTIVE: To examine the influence of individual- and area-level socio-economic characteristics on food choice behaviour and dietary intake. SETTING: The city of Eindhoven in the south-east Netherlands. DESIGN: A total of 1339 men and women aged 25-79 years were sampled from 85 areas (mean number of participants per area = 18.4, range 2-49). Information on socio-economic position (SEP) and diet was collected by structured face-to-face interviews (response rate 80.9%). Individual-level SEP was measured by education and household income, and area-level deprivation was measured using a composite index that included residents' education, occupation and employment status. Diet was measured on the basis of (1) a grocery food index that captured compliance with dietary guidelines, (2) breakfast consumption and (3) intakes of fruit, total fat and saturated fat. Multilevel analyses were performed to examine the independent effects of individual- and area-level socio-economic characteristics on the dietary outcome variables. RESULTS: After adjusting for individual-level SEP, few trends or significant effects of area deprivation were found for the dietary outcomes. Significant associations were found between individual-level SEP and food choice, breakfast consumption and fruit intake, with participants from disadvantaged backgrounds being less likely to report food behaviours or nutrient intakes consistent with dietary recommendations. CONCLUSIONS: The findings suggest that an individual's socio-economic characteristics play a more important role in shaping diet than the socio-economic characteristics of the area in which they live. In this Dutch study, no independent influence of area-level socio-economic characteristics on diet was detected, which contrasts with findings from the USA, the UK and Finland.     

Television viewing behaviour and associations with food habits in different countries

OBJECTIVE: Several environmental factors influence adolescents' food habits and television (TV) viewing is thought to be one of these factors. The purpose of the present study was to describe sociodemographic differences in TV viewing and to examine associations of TV viewing with the consumption of sweets, soft drinks, fruit and vegetables in different countries. METHODS: Data were collected from 162,305 young people completing the 2001/02 Health Behaviour in School-Aged Children survey, a World Health Organization cross-national study on health and health behaviours among 11-, 13- and 15-year-old school pupils. Analyses of variance were used to examine sociodemographic differences in TV viewing and logistic regression analyses to examine associations between TV viewing and food habits. RESULTS: Large differences were found between countries in reported daily TV viewing time, from an average of 2.0 h in Switzerland to 3.7 h in Ukraine. The results indicate that those most likely to watch TV are boys, 13-year-olds and pupils of lower socio-economic status. Those who watched more TV were more likely to consume sweets and soft drinks on a daily basis and less likely to consume fruit and vegetables daily, although the latter associations were not so apparent among Central and Eastern European countries. CONCLUSIONS: Given the high TV viewing rates among adolescents and the association with less healthy food options, many young people are at increased risk of overweight or obesity. Interventions to modify TV viewing behaviour are needed. The findings underscore the importance of tackling socio-economic differences.     

中国水资源和粮食安全问题探讨

中国是世界人口最多的发展中国家,用占全球7%的土地、8%的淡水养活占全球22%的人口.但随着人口的持续增长,气候干旱和生态境破坏以及污染的不断扩大和加重,水和耕地资源的不断减少,中国在水资源和粮食安全方面将面临巨大的压力与挑战.中国干旱半干旱的西北地区,有70%左右的贫困人口,粮食安全问题长期存在,经济发展缓慢.目前中国政府实施的西部大开发战略,减免农业税费,增加经济投入和水利工程等建设项目,是解决西北地区贫困的关键.