• Nutrition Research and Practice
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• v.12 no.2
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• pp.135-142
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• 2018

BACKGROUND/OBJECTIVES: This cross-sectional study assessed household food security status and determined its association with diet quality and weight status among indigenous women from the Mah Meri tribe in Peninsular Malaysia. SUBJECTS/METHODS: The Radimer/Cornell Hunger and Food Insecurity Instrument and the Malaysian Healthy Eating Index (HEI) were used to assess household food security status and diet quality, respectively. Information on socio-demographic characteristics and 24-hour dietary recall data were collected through face-to-face interview, and anthropometric measurements including weight, height, and body mass index (BMI) were obtained from 222 women. RESULTS: Majority of households (82.9%) experienced different levels of food insecurity: 29.3% household food insecurity, 23.4% individual food insecurity, and 30.2% fell into the child hunger group. The food-secure group had significantly fewer children and smaller household sizes than the food-insecure groups (P < 0.05). The mean household income, income per capita, and food expenditure significantly decreased as food insecurity worsened (P < 0.001). The food-secure group had significantly higher Malaysian HEI scores for grains and cereals (P < 0.01), as well as for meat, poultry, and eggs (P < 0.001), than the food-insecure groups. The child-hunger group had significantly higher fat (P < 0.05) and sodium (P < 0.001) scores than the food-secure and household food-insecure groups. Compared to the individual food-insecure and child-hunger groups, multivariate analysis of covariance showed that the food-secure group was significantly associated with a higher Malaysian HEI score while the household food-insecure group was significantly associated with a higher BMI after controlling for age (P < 0.025). CONCLUSIONS: The majority of indigenous households faced food insecurity. Food insecurity at the individual and child levels was associated with lower quality of diet, while food insecurity at the household level was associated with higher body weight. Therefore, a substantial effort by all stakeholders is warranted to improve food insecurity among poorer households. The results suggest a pressing need for nutritional interventions to improve dietary intake among low income households.

• Journal of Nutrition and Health
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• v.40 no.8
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• pp.762-768
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• 2007

This study examined household food insecurity and the associations of food insecurity with socioeconomic conditions, food behaviors, and nutrient intakes among 458 older adults(mean age=$73.2{\pm}4.5$) from 5 clusters of low-income areas in Seoul, Korea. Using an adapted version of the USDA short form household food insecurity scale, 63.4% of the households were food insecure(40.7% for food insecure without hunger and 22.7% for food insecure with hunger). The proportion of household was lower on the items measured more severe level of food insecurity. Food insecurity was linearly and negatively associated with food expenditure, food secured period and the degree of nutrition management skills, health status and depression. Food secure older adults had mere of energy and other nutrients from animal resources(riboflavin and animal protein, fat and calcium), but less of carbohydrates than those from the food insecure households. These results suggest household food insecurity measures used in this study was valid as well as food insecurity was prevalent and an important indicator of nutrition well-being among low income elderly persons.

• Nutrition Research and Practice
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• v.8 no.3
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• pp.304-311
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• 2014

BACKGROUND/OBJECTIVES: The purpose of the study was to investigate the relationship between household food insecurity and nutritional status of children in low-income households. A cross sectional study involved a survey of households (n = 223) receiving the financial assistance. SUBJECTS/METHODS: Eligible mothers that fulfilled the inclusion criteria such as non-pregnant, non-lactating mothers, aged 18 to 55 years with their youngest children aged 2 to 12 years, were purposively selected. The Radimer/Cornell hunger and food-insecurity instrument was administered and children's height and weight were measured. RESULTS: About 16.1% of the households were food secure, while 83.9% experienced some kind of food insecurity. Out of food insecure category, 29.6% households were food insecure, 19.3% women were individual food insecure and 35.0% fell into the child hunger category. Education of the mother (P = 0.047), household size (P = 0.024), number of children (P = 0.024), number of children going to school (P = 0.048), total monthly income (P < 0.001), income per capital (P < 0.001), number of household members contributing to the income (P = 0.018) and food expenditure (P = 0.006) were significant risk factors for household food insecurity. The prevalence of underweight, stunting and wasting in children were 61.0%, 61.4% and 30.6% respectively. Based on multinomial logistic regression, children in food-insecure households were 2.15 times more likely to be underweight and three times to be stunted than children in the food-secure households. CONCLUSIONS: The findings suggest that household food insecurity is associated with the nutritional status of the children in the rural area of Northeastern Peninsular Malaysia.

• Nutrition Research and Practice
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• v.2 no.1
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• pp.26-34
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• 2008

This cross-sectional study assessed household food insecurity among low-income rural communities and examined its association with demographic and socioeconomic factors as well as coping strategies to minimize food insecurity. Demographic, socioeconomic, expenditure and coping strategy data were collected from 200 women of poor households in a rural community in Malaysia. Households were categorized as either food secure (n=84) or food insecure (n=116) using the Radimer/Cornell Hunger and Food Insecurity instrument. T-test, Chi-square and logistic regression were utilized for comparison of factors between food secure and food insecure households and determination of factors associated with household food insecurity, respectively. More of the food insecure households were living below the poverty line, had a larger household size, more children and school-going children and mothers as housewives. As food insecure households had more school-going children, reducing expenditures on the children's education is an important strategy to reduce household expenditures. Borrowing money to buy foods, receiving foods from family members, relatives and neighbors and reducing the number of meals seemed to cushion the food insecure households from experiencing food insufficiency. Most of the food insecure households adopted the strategy on cooking whatever is available at home for their meals. The logistic regression model indicates that food insecure households were likely to have more children (OR=1.71; p<0.05) and non-working mothers (OR=6.15; p<0.05), did not own any land (OR=3.18; p<0.05) and adopted the strategy of food preparation based on whatever is available at their homes (OR=4.33; p<0.05). However, mothers who reported to borrow money to purchase food (OR=O.84; p<0.05) and households with higher incomes of fathers (OR=O.99; p<0.05) were more likely to be food secure. Understanding the factors that contribute to household food insecurity is imperative so that effective strategies could be developed and implemented.

• Nutrition Research and Practice
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• v.17 no.2
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• pp.269-283
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• 2023

BACKGROUND/OBJECTIVES: This study aimed to examine the food security status of urban poor adolescents and its association with diet quality. SUBJECTS/METHODS: A cross-sectional survey was conducted among 188 adolescents aged 13-18 yrs living in Kuala Lumpur, Malaysia. Household food insecurity and dietary intake data were collected using the Radimer/Cornell hunger and food insecurity instrument and 2-day 24-h dietary recalls, respectively. Diet quality was determined using the Malaysian Healthy Eating Index (HEI). Weight and height were measured and body mass index-for-age, as well as height-for-age z scores were calculated. RESULTS: The present study revealed that 47.9% of the adolescents experienced household food insecurity, 24.5% experienced individual food insecurity, 18.6% household food security, and 9.0% child hunger. The mean score of diet quality was 56.83 ± 10.09, with a significantly lower HEI score among food insecure adolescents (household food insecure, individual food insecure, and child hunger) than household food secure adolescents (P = 0.001). The differences between food secure and food insecure households were found to be significant for energy (P = 0.001) and nutrients including proteins (P = 0.006), carbohydrates (P = 0.005), dietary fiber (P = 0.001), folate (P < 0.001), and vitamin C (P = 0.006). The multiple linear regression showed that adolescents who experienced food insecurity (β = -0.328; P = 0.003) were found to be significantly associated with poor diet quality (F = 2.726; P < 0.01), wherein 13.3% of the variation in the diet quality was explained by the food security status. CONCLUSIONS: Experiencing food insecurity contributed to poor diet quality among urban poor adolescents. Further longitudinal studies are needed to comprehensively understand this association to improve food insecurity and diet quality among urban poor communities.

• The Korean Journal of Community Living Science
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• v.20 no.1
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• pp.19-32
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• 2009

The purpose of this study was to examine household food insecurity and the associations of food insecurity with socioeconomic characteristics, food behaviors, health status and nutrient intake among elderly people in a rural area. This study included 191 elderly people (mean age = $72.0{\pm}7.4$) in Jeollabuk-do, Jangsu-gun. House food insecurity was measured using an adapted version of the USDA short form household food insecurity scale, and nutrient intake measured by a 24-hour dietary recall. Only 15.2% of the subjects were in food-insecure households, 84.8% of the elderly households were food-secure. The food-insecure households were significantly lower in the number of family, frequency of shopping, and perceived health status than the food-secure households. In addition, they had serious tooth problems and NSI (Nutrition Screening Index) scores. Food-insecure households were significantly lower in most areas of nutrient intake (energy, protein, fat, Ca, P, Fe, K, Na, Zn, Vit. $B_2$, niacin, Vit. E), and also lower in nutrient intake compared to dietary reference intake (energy, protein, P, Fe, K, Na, Vit. $B_1$, Vit. $B_2$, niacin, Vit. E). These results suggest that the household food insecurity measures used in this study were an important indicator of nutritional well-being among elderly persons in the rural area. Food insecurity should be considered an important issue to public health and food service programs should be expanded for food-insecure households in rural areas.

• Health Policy and Management
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• v.32 no.2
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• pp.216-227
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• 2022

Background: Food insecurity may contribute to mental health indicators such as stress, anxiety, or depression. We investigated whether food insecurity was associated with mental health indicators and health-related quality of life (HRQoL) in a representative sample of the Korean population. Methods: This study enrolled 12,987 adults without a history of medically serious disease from the 2012, 2013, and 2015 Korea National Health and Nutrition Examination Survey. Household food security status was categorized as "food security," "mild food insecurity," and "moderate/severe food insecurity." The association between mental health and HRQoL was evaluated using a multivariate logistic regression model with food security as the reference group. Results: The adjusted odds ratio of adverse mental health or low HRQoL increased significantly in mild or moderate/severe food insecurity compared to food security. In the moderate/severe food insecurity group, it was 1.98% (95% confidence interval [CI], 1.31-2.99) higher for perceived stress, 3.58% (95% CI, 2.44-5.26) higher for depression symptoms, 4.16% (95% CI, 2.68-6.45) higher for suicidal ideation, and 2.81% (95% CI, 1.91-4.15) higher for quality of life. Conclusion: Food insecurity was strongly associated with negative mental health status and poor HRQoL. There is a need for a dietary support program that provides psychosocial support to those experiencing food insecurity.

• Journal of the Korean Dietetic Association
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• v.21 no.4
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• pp.308-319
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• 2015

The purpose of this study was to assess risk factors associated with food insecurity in the Korean elderly aged over 65 years using data from the Korea National Health & Nutrition Examination Survey 2013 (KNHANES VI). A total of 1,200 subjects were analyzed among the participants of the KNHANES 2013 by using SPSS statistics complex samples (ver. 21.0). Food insecurity was measured by using the modified US Household Food Security/Hunger Survey Module. Thirteen percent of subjects lived in food insecure households. There were differences in the prevalence of food insecurity according to sex, educational level, income level, and household structure. Mean age of the food insecurity group was significantly higher than that of the food security group. The results of logistic regression analysis showed that food insecurity was significantly associated with alcohol intake (OR: 1.82), prevalence of melancholy (OR: 2.07) and suicidal thoughts (OR: 2.67), and intake deficiency of energy (OR: 1.60), calcium (OR: 1.97), iron (OR: 1.97), potassium (OR: 1.96), riboflavin (OR: 1.76), and niacin (OR: 1.64), while not with smoking, physical activity, chronic diseases including obesity, anemia, diabetes, and osteoarthritis, and deficiency of protein, vitamin A, thiamin and vitamin C. These findings suggest that food insecurity is strongly related to mental health and certain nutrient intakes. Prospective research is needed to establish the effects of food insecurity on chronic diseases.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.23 no.5
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• pp.447-456
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• 2020

Purpose: Food insecurity, which is the inability to obtain food or inadequate food consumption in terms of quality and quantity, has physical and psychological consequences on children's health. This study aimed to investigate the relationship between children's growth disorders and food insecurity in Qazvin city, Iran. Methods: A case-control study was conducted on 177 cases and 355 controls of children aged 3 to 6 years, who were referred to health centers in Qazvin city. The case group consisted of children with growth disorders. Data were obtained with the 18-item US Department of Agriculture questionnaire, a household socioeconomic questionnaire, a and growth monitoring card. The data were analyzed with using IBM SPSS Version 22.0, by independent sample t-test, chi-square test, and logistic regression. Results: A significant relationship was found between children's growth disorders and household food insecurity with (p<0.05, odds ratio [OR]=17.0, confidence interval [CI]=5.9, 48.8) and without hunger (p<0.05, OR=2.69, CI=1.4, 4.9). There were also significant relationships between children's growth disorders and socioeconomic status (p<0.05, OR=3.4, CI=1.4, 8.5), the duration of breastfeeding (p<0.05, OR=0.94, CI=0.9, 0.98), and children's ages (p<0.05, OR=0.94, CI=0.92, 0.96). Sex and birth order, and the age of the parents was not found to be significantly related with growth disorders. Conclusion: Lower socioeconomic status and household food insecurity were the important predictors of children's growth disorders. Policymakers should focus more on promoting steady employment and income among family members. Nutritional education for mothers is also recommended, in order to better meet the nutritional needs of the children.

• Journal of Nutrition and Health
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• v.56 no.3
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• pp.264-276
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• 2023

Purpose: Food environmental factors related to food insecurity affect household food intake in several socio-ecological aspects. This study explores the relationship between food environment factors and food insecurity in households with married immigrant women. Methods: From November 2018 to February 2020, a survey was conducted enrolling 249 married immigrant women residing in the metropolitan areas of South Korea. In the final analysis, 229 subjects were divided into 2 groups classified as food security (n = 154) and food insecurity (n = 75), as assessed by the score of food security. Three aspects of food environments were measured: built·natural, political·economic, and socio-cultural Results: Food environments were significantly different between food security and food insecurity groups, as follows: the number of foods market and their distance from the home and food status for the last week at home in the built·natural domain; monthly cost of food purchase and experience for food assistance in the political·economic domain; total score of social support, parenting, and cooking skills in the socio-cultural domain. A stepwise multivariate linear regression model showed a negative association between the food insecurity score with social support from family and food inventory status in the last week. After adjusting for confounders, a positive association was obtained between the experience of a food support program. The final regression model explains about 30% of the relationship obtained in the three food environment domains and food insecurity (p < 0.001). Conclusion: Not only economic factors, which are common determinants of household food insecurity, but socio-cultural factors such as social support also affect household food insecurity. Therefore, plans for implementing a food assistance program to improve food insecurity for households with immigrant women should consider financial support as well as other comprehensive aspects, including socio-cultural domain such as social support from family and community.