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.     

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.     

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, 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.     

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.     

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.     

Hunger in young children of Mexican immigrant families

OBJECTIVE: To measure rates of hunger and food insecurity among young US-born Latino children with Mexican immigrant parents (Latinos) compared with a non-immigrant non-Latino population (non-Latinos) in a low-income clinic population. DESIGN, SETTING AND SUBJECTS: A repeated cross-sectional survey of 4278 caregivers of children < 3 years of age in the paediatric clinic of an urban county hospital for a 5-year period from 1998 to 2003. A total of 1310 respondents had a US-born child with at least one parent born in Mexico. They were compared with a reference group comprised of non-Latino US-born participants (n = 1805). Child hunger and household food insecurity were determined with the US Household Food Security Scale. RESULTS: Young Latino children had much higher rates of child hunger than non-Latinos, 6.8 versus 0.5%. Latino families also had higher rates of household food insecurity than non-Latinos, 53.1 versus 15.6%. Latino children remained much more likely to be hungry (odds ratio (OR) = 13.0, 95% confidence interval (CI) = 5.9-28.7, P < 0.01) and in household food-insecure households (OR = 6.6, 95% CI = 5.2-8.3, P < 0.01) than non-Latinos after controlling for the following variables in multivariate analysis: child's age, sex, maternal education level, single-headed household status, family size, young maternal age ( < 21 years), food stamp programme participation, TANF (Temporary Assistance to Needy Families, or 'welfare') programme participation and WIC (Women, Infants, and Children) usage, and reason for clinic visit (sick visit versus well-child). CONCLUSION: Young children in Mexican immigrant families are at especially high risk for hunger and household food insecurity compared with non-immigrant, non-Latino patients in a low-income paediatric clinic.     

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.     

Food insecurity and subsequent weight gain in women

OBJECTIVE: Cross-sectional data indicate that a relationship between household food insecurity and overweight exists among women in the USA. Cross-sectional data cannot determine if food insecurity leads to overweight as some have hypothesised. The purpose of the present study was to examine the relationship of food insecurity with subsequent weight gain in women using data from the Panel Study of Income Dynamics (PSID). DESIGN, SETTING AND SUBJECTS: Panel data from the 1999 and 2001 PSID, a nationally representative sample of households, were analysed using multivariate regression procedures.RESULTS: Average weight gain among all women (n = 5595) was 1.1 kg on average over the two years. There were no significant differences in the percentages of women who gained a clinically significant amount (2.3 kg) by food insecurity status. Overweight women who were on a weight-gain trajectory during the 2-year period gained less if they were food-insecure. This relationship was not observed among healthy-weight or obese women. CONCLUSIONS: Overall, food insecurity does not appear to be strongly associated with subsequent weight gain in women.     

Self-administration of a food security scale by adolescents: item functioning, socio-economic position and food intakes

OBJECTIVE: To evaluate the reliability and validity of a six-item food security scale when self-administered by adolescents. DESIGN: Cross-sectional questionnaire survey including the six-item food security measure, socio-economic variables and a food-frequency questionnaire. SETTING: Representative sample of 29 schools in Trinidad. SUBJECTS: In total 1903 students aged approximately 16 years. RESULTS: Item affirmatives ranged from 514 (27%) for the 'balanced meal' item to 128 (7%) for the 'skipped or cut meals often' item and 141 (7%) for the 'hungry' item. Item-score correlations ranged from 0.444 to 0.580. Cronbach's alpha was 0.77. Relative item severities from the Rasch model ranged from -1.622 (standard error 0.043) for the 'balanced meal' item to 1.103 (0.068) for the 'skipped or cut meals often' item and 0.944 (0.062) for the 'hungry' item. The 'hungry' item gave a slightly lower relative severity in boys than girls. Food insecurity was associated with household overcrowding (adjusted odds ratio comparing highest and lowest quartiles 2.61, 95% confidence interval 1.75 to 3.91), lack of pipe-borne water in the home, low paternal education or paternal unemployment. After adjusting for socio-economic variables, food insecurity was associated with less frequent consumption of fruit (0.75, 0.60 to 0.94) or fish (0.72, 0.58 to 0.88) but more frequent consumption of biscuits or cakes (1.47, 1.02 to 2.11). CONCLUSIONS: The food security scale provides a valid, reliable measure in adolescents, although young people report being hungry but not eating relatively more frequently than adults. Food-insecure adolescents have low socio-economic position and may eat less healthy diets.     

Is the adapted Radimer/Cornell questionnaire valid to measure food insecurity of urban households in Tehran, Iran?

OBJECTIVE: To assess the validity of the adapted Radimer/Cornell questionnaire to measure food insecurity in low-income urban households in Tehran, the capital of Iran. DESIGN: The Radimer/Cornell questionnaire was modified and used to assess the applicability, validity and reliability of such a measure in a culturally different context of urban households in Tehran. Factor analysis and Cronbach's alpha were used to assess validity and reliability, respectively. Socio-economic characteristics and food consumption frequency of the household were used to assess the criterion validity of the questionnaire. SETTING: District 20 of Tehran. SUBJECTS: A sample of 250 Iranian nuclear households with at least one child aged 1-18 years and a non-pregnant, non-lactating woman of reproductive age, selected through a multistage random sampling method. RESULTS: Three scales, labelled as household, individual and child hunger, were extracted through factor analysis using varimax rotation. Internal consistency of the scales was 0.897, 0.820 and 0.796, respectively. Individual insecurity and child hunger were inversely correlated with monthly per capita income, father's education, mother's education and father's occupational status, and positively correlated with household size, as expected. However, household insecurity did not follow the same pattern. Consumption frequency of fruits, vegetables, dairy, red meat and rice declined as food insecurity status worsened, while bread and potato consumption increased. CONCLUSION: The results show that a modified version of the Radimer/Cornell questionnaire is a valid and reliable instrument to measure household food insecurity in a culturally different context. However, further modifications seem necessary to measure food insecurity at household level. Results lend support to the utility and applicability of experience-based measures in varying cultural communities.     

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.     

基于水土流失的赣州市生态安全评价

为定量评价赣州地区30 a来水土流失治理对生态环境变化的影响,基于水土流失状况构建了赣州市生态安全评价指标体系。利用"压力—状态—响应"模型,从水土流失角度,采用频度统计法和专家咨询法,构建了17个评价指标,首次对赣州地区生态安全状况进行了评价。结果表明:(1)经过30 a的水土流失治理,赣州地区生态安全水平得到明显提高,但局部地区出现了不同程度降低,整体生态安全等级处于Ⅲ级水平,生态环境有待进一步的改善;(2)赣州地区水土流失与生态安全呈现明显的负相关性,经过30 a的水土流失治理,赣州市水土流失与生态安全的负相关性逐渐减弱,水土流失对该地区的生态安全影响逐步降低,因此,水土保持是改善该地区生态环境的重要途径之一。     

Hunger and health among undocumented Mexican migrants in a US urban area

OBJECTIVES: To measure the occurrence and correlates of hunger and to evaluate the association between hunger and three health indicators among undocumented Mexican immigrants. DESIGN: Non-probability cross-sectional sample. SETTING: Neighbourhoods within New York City. SUBJECTS: Four hundred and thirty-one undocumented Mexican immigrants living in the USA. RESULTS: Hunger was indicated by approximately 28% of respondents. In a multivariate model, working as a day labourer was associated with hunger (odds ratio (OR) 3.33, 95% confidence interval (CI) 1.83-6.06) while receiving public assistance protected against hunger (OR 0.23, 95% CI 0.06-0.88). In multivariate models, respondents who reported experiencing hunger also reported poorer overall health (OR 1.69, 95% CI 0.95-3.02) and more days of poor mental (P = 0.045) and physical health (P < 0.0001). Greater amount of time lived in the USA was also associated with worse overall health (P = 0.054) and more days of poor mental and physical health (P < 0.01). CONCLUSIONS: The present study shows that food insecurity and hunger may be problems among undocumented migrants living in the USA. Uncertain and unpredictable work schedules and limited access to public assistance may contribute to high levels of hunger, which in turn may also negatively affect mental and physical health. Increasing amount of time lived in the USA is also associated with poorer health indicators. Programmes that provide undocumented migrants with emergency access to resources may reduce food insecurity and lead to improved health outcomes among this vulnerable population.     

Food insecurity, malnutrition and mortality in Maewo and Ambae Islands, Vanuatu

CONTEXT: This paper reports on findings from the ex-post evaluation of the Maewo Capacity Building project in Maewo Island, Vanuatu, which was funded by World Vision Australia. OBJECTIVES: To examine the extent to which the infrastructure and systems left behind by the project contributed to the improvement of household food security and health and nutritional outcomes in Maewo Island, using Ambae Island as a comparator. SETTING: Two-stage cluster survey conducted from 6 to 20 July 2004, which included anthropometric measures and 4.5-year retrospective mortality data collection. PARTICIPANTS: A total of 406 households in Maewo comprising 1623 people and 411 households in Ambae comprising 1799 people. MAIN OUTCOME MEASURES: Household food insecurity, crude mortality rate (CMR), under-five mortality rate (U5MR) and malnutrition prevalence among children. RESULTS: The prevalence of food insecurity without hunger was estimated at 15.3% (95% confidence interval (CI): 12.1, 19.2%) in Maewo versus 38.2% (95% CI: 33.6, 43.0%) in Ambae, while food insecurity with hunger in children did not vary by location. After controlling for the child's age and gender, children in Maewo had higher weight-for-age and height-for-age Z-scores than children of the same age in Ambae. The CMR was lower in Maewo (CMR = 0.47/10 000 per day, 95% CI: 0.39, 0.55) than in Ambae (CMR=0.59/10 000 per day, 95% CI: 0.51, 0.67) but no difference existed in U5MR. The major causes of death were similar in both locations, with frequently reported causes being malaria, acute respiratory infection and diarrhoeal disease. CONCLUSIONS: Project initiatives in Maewo Island have reduced the risks of mortality and malnutrition. Using a cross-sectional 'external control group' design, this paper demonstrates that it is possible to draw conclusions about project effectiveness where baseline data are incomplete or absent. Shifting from donor-driven evaluations to impact evaluations has greater learning value for the organisation, and greater value when reporting back to the beneficiaries about project impact and transformational development in their community. Public health nutritionists working in the field are well versed in the collection and interpretation of anthropometric data for evaluation of nutritional interventions such as emergency feeding programmes. These same skills can be used to conduct impact evaluations, even some time after project completion, and elucidate lessons to be learned and shared. These skills can also be applied more widely to projects which impact on the longer-term nutritional status of communities and their food security.     

The targeting of nutritionally at-risk children attending a primary health care facility in the Western Cape Province of South Africa

AIM: The aim of this study was to determine the practices of primary health care (PHC) nurses in targeting nutritionally at-risk infants and children for intervention at a PHC facility in a peri-urban area of the Western Cape Province of South Africa. METHODOLOGY: Nutritional risk status of infants and children <6 years of age was based on criteria specified in standardised nutrition case management guidelines developed for PHC facilities in the province. Children were identified as being nutritionally at-risk if their weight was below the 3rd centile, their birth weight was less than 2500 g, and their growth curve showed flattening or dropping off for at least two consecutive monthly visits. The study assessed the practices of nurses in identifying children who were nutritionally at-risk and the entry of these children into the food supplementation programme (formerly the Protein-Energy Malnutrition Scheme) of the health facility. Structured interviews were conducted with nurses to determine their knowledge of the case management guidelines; interviews were also conducted with caregivers to determine their sociodemographic status. RESULTS: One hundred and thirty-four children were enrolled in the study. The mean age of their caregivers was 29.5 (standard deviation 7.5) years and only 47 (38%) were married. Of the caregivers, 77% were unemployed, 46% had poor household food security and 40% were financially dependent on non-family members. Significantly more children were nutritionally at-risk if the caregiver was unemployed (54%) compared with employed (32%) (P=0.04) and when there was household food insecurity (63%) compared with household food security (37%) (P<0.004). Significantly more children were found not to be nutritionally at-risk if the caregiver was financially self-supporting or supported by their partners (61%) compared with those who were financially dependent on non-family members (35%) (P=0.003). The weight results of the nurses and the researcher differed significantly (P<0.001), which was largely due to the different scales used and weighing methods. The researcher's weight measurements were consistently higher than the nurses' (P<0.00). The researcher identified 67 (50%) infants and children as being nutritionally at-risk compared with 14 (10%) by the nurses. The nurses' poor detection and targeting of nutritionally at-risk children were largely a result of failure to plot weights on the weight-for-age chart (55%) and poor utilisation of the Road to Health Chart. CONCLUSIONS: Problems identified in the practices of PHC nurses must be addressed in targeting children at nutritional risk so that appropriate intervention and support can be provided. More attention must be given to socio-economic criteria in identifying children who are nutritionally at-risk to ensure their access to adequate social security networks.     

Dietary intake among under-, normal- and overweight 9- and 15-year-old Estonian and Swedish schoolchildren

OBJECTIVES: To determine the differences in macronutrient and food group contribution to total food and energy intakes between Estonian and Swedish under-, normal- and overweight schoolchildren, and to estimate the association between diet and body mass index (BMI). DESIGN: Cross-sectional comparison between Estonian and Swedish children and adolescents of different BMI groups. SETTING: Twenty-five schools from one region in Estonia and 42 in two regions of central Sweden. SUBJECTS: In total 2308 participants (1176 from Estonia and 1132 from Sweden), including 1141 children with a mean age of 9.6 +/- 0.5 years and 1167 adolescents with a mean age of 15.5 +/- 0.6 years. RESULTS: Overweight was more prevalent among younger girls in Sweden (17.0 vs. 8.9%) and underweight among girls of both age groups in Estonia (7.9 vs. 3.5% in younger and 10.5 vs. 5.1% in older age group of girls). Compared with that of normal- and underweight peers, the diet of overweight Estonian children contained more energy as fat (36.8 vs. 31.7%) but less as carbohydrates, and they consumed more milk and meat products. Absolute BMI of Estonian participants was associated positively with energy consumption from eggs and negatively with energy consumption from sweets and sugar. Swedish overweight adolescents tended to consume more energy from protein and milk products. Risk of being overweight was positively associated with total energy intake and energy from fish or meat products. In both countries the association of overweight and biological factors (pubertal maturation, parental BMI) was stronger than with diet. CONCLUSION: The finding that differences in dietary intake between under-, normal- and overweight schoolchildren are country-specific suggests that local dietary habits should be considered in intervention projects addressing overweight.     

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.     

Improving the nutritional status of food-insecure women: first, let them eat what they like

OBJECTIVE: To determine the extent to which identified nutrient inadequacies in the dietary intakes of a sample of food-insecure women could be ameliorated by increasing their access to the 'healthy' foods they typically eat. DESIGN: Merged datasets of 226 food-insecure women who provided at least three 24-hour dietary intake recalls over the course of a month. Dietary modelling, with energy adjustment for severe food insecurity, explored the effect of adding a serving of the woman's own, and the group's typically chosen, nutrient-rich foods on the estimated prevalence of nutrient inadequacy. SETTING AND SUBJECTS: One study included participants residing in 22 diverse community clusters from the Atlantic Provinces of Canada, and the second study included food bank attendees in Toronto, Ontario, Canada. Of the 226 participants, 78% lived alone with their children. RESULTS: While nutritional vulnerability remained after modelling, adding a single serving of either typically chosen 'healthy' foods from women's own diets or healthy food choices normative to the population reduced the prevalence of inadequacy by at least half for most nutrients. Correction for energy deficits resulting from severe food insecurity contributed a mean additional 20% improvement in nutrient intakes. CONCLUSIONS: Food-insecure women would sustain substantive nutritional gains if they had greater access to their personal healthy food preferences and if the dietary compromises associated with severe food insecurity were abated. Increased resources to access such choices should be a priority.