Soda Consumption Among Food Insecure Households with Children: A Call to Restructure Food Assistance Policy

The nutritional problems of food insecurity and obesity co-exist among low-income children. As the reauthorization of SNAP approaches in 2012, it is time to consider the dietary intake of food insecure children and how the SNAP program can assist with improving the nutrition of low-income children, in addition to contributing to reducing the prevalence rates of childhood obesity among food insecure households with children

Lessons Learned from Conducting Health Behavior Research in an Under-Resourced, Urban Community

Existing literature discusses challenges in conducting community-engaged health behavior interventions. However, discussions associated with the barriers to executing community-engaged health behavior research with vulnerable populations are limited in the literature. This current issue provides lessons learned for the purpose of improving community-engaged research within communities that are under-resourced. The lessons learned stem from challenges with the recruitment and enrollment procedures and study design with a previous qualitative community-engaged research project. The research recommendations proposed are geared toward students preparing to engage in dissertation research and early-stage investigators who are interested in conducting research in under-resourced communities

Food Insecurity as a Predictor of Hurricane Exposure among Underserved Adolescents

Low-income populations are at increased risk for experiencing negative hurricane exposures and food insecurity. However, little is known regarding how pre-hurricane food insecurity experiences are related to youth hurricane exposure. This study examined the types of hurricane disaster exposures low-income, ethnic minority adolescents experienced during Hurricane Harvey and examined the association between food insecurity and hurricane exposure. Low-income adolescents (n = 185) were recruited from a Houston-area school district. Two days before the hurricane, food insecurity was assessed. Adolescents with at least one affirmative answer on the 9-item USDA Child Food Security Survey Module were classified as food insecure. Adolescents self-reported hurricane exposure three weeks post-hurricane using both the National Child Traumatic Stress Network Hurricane and Assessment Referral Tool and Survey of Hurricane Katrina Evacuees. Affirmative answers to lacking access to food, water, or medicine, being rescued, home damage, and displacement were each given a score of one and summed to create an overall hurricane exposure score. A covariate-adjusted linear regression model regressed overall hurricane exposure onto food insecurity. Separate covariate-adjusted logistic regression models were performed where each individual hurricane exposure was regressed onto food insecurity. Prior to the hurricane, 46% of adolescents experienced food insecurity and 43% experienced hurricane exposure. Pre-hurricane food insecurity (p = 0.004) and being foreign born (p = 0.033) were associated with increased hurricane exposure. Adolescents who experienced food insecurity had 132% higher odds of lacking access to fresh water (p = 0.047) and 105% higher odds of lacking access to food (p = 0.034) during the hurricane. Food insecurity and immigrant status appear to be at-risk indicators for hurricane exposure. Schools serving underserved adolescents could consider assessing food security and immigration status as part of disaster preparedness programs

Family Structure and Income Volatility: Association with Food Stamp Program Participation

Using the Fragile Families and Child Well-Being Study, this paper investigates how income volatility and union stability and transitions influence patterns in Food Stamp Program (FSP) participation among a sample of young families (n=1263). Multinomial logistic regression models suggest that families that experience significant declines in income are related to constant and transitional participation. Families that stay married are more likely not to participate, while other stable unions (e.g., stably cohabitating couples and stably singles) and unions in transition are associated with always participating. We also found immigration status, health, public agency support, public health insurance, and housing assistance from the government or friends/family, to be significant in predicting participation. Strategies to increase participation are discussed.food stamp program participation, income volatility, union transitions, cohabitation, fragile families

Adult Food Insecurity is Associated with Heavier Weight Preferences among Black Women

Food insecurity is related to overweight/obesity among women. However, it is unknown whether food insecurity impacts individuals’ desired body composition, and whether this relationship differs by race/ethnicity similar to perceived ideal weight status. This study aims to evaluate whether food insecurity is related to elevated preferred weight status (e.g., overweight/obese versus normal weight) among black, white, and Hispanic women classified as overweight/obese. Four waves of NHANES data (2007–2014) were merged and yielded a total of 907 black, 1,271 white, and 1,005 Hispanic non-pregnant adult (age 20 to 59) women classified as overweight/obese. Participants self-reported their preferred weight status, adult-level food security, and demographic covariates. Covariate-adjusted logistic regression models stratified by race/ethnicity evaluated the role of food insecurity related to preferred weight status. Among black women, those who were food insecure were at 51% increased odds of preferring an overweight/obese weight status (OR: 1.51; 95% CI: 1.08 – 2.13; p = .02) relative to their food secure counterparts. Among white and Hispanic women, those who were food insecure had similar odds of preferring an overweight/obese weight status (White: OR: 1.07; 95% CI: 0.68 – 1.71; p = .76; Hispanic: OR: 0.95; 95% CI: 0.66 – 1.37; p = .77) relative to their food secure counterparts. Food insecurity results in the desire to be heavier among black women classified as overweight/obese. However, it does not impact white and Hispanic women classified as overweight/obese. Practitioners must consider weight preferences prior to providing obesity prevention information, particularly among food insecure black women

Advancing Health Behavior Research and Scholarship through Mentorship of First Generation, Underrepresented Undergraduate Students

This article provides perspectives about mentorship of undergraduate mentees from directors of formal, externally funded training programs within the context of one of the most ethnically diverse national universities. The authors reflect about their mentorship of first generation and underrepresented undergraduate students and offer recommendations for others training similar students

Multidisciplinary approaches to address food insecurity and nutrition among youth and their families

Our aim in publishing this issue of JARC on nutrition and food insecurity is to understand the factors associated with nutrition and food insecurity in the U.S. and around the world; to elucidate the potential consequences of food insecurity on physical and mental health; and to raise awareness and identify solutions to address this complex issue. We also aim to encourage collaboration across disciplines in order to frame initiatives that reduce these threats to child health, well-being and success

Household food insecurity status and Hispanic immigrant children’s body mass index and adiposity

Objectives: Despite the high prevalence rates of food insecurity and obesity among children of Hispanic immigrants, there has been a dearth of research on the direct relationship between food insecurity and obesity among this population. Further, prior research examining the association between food insecurity and body composition among children of Hispanic immigrants have not considered adiposity, specifically percent body fat (%BF) and waist circumference (WC), as outcome measurements. The following study contributes to the literature by examining the association between food insecurity and two adiposity measurements, %BF and WC, along with body mass index (BMI) among a sample of young Hispanic immigrant children. Methods: Cross-sectional survey and direct body composition assessments were collected among 49 low-income Hispanic immigrant children (mean age = 5.5. years) and their 44 mothers (mean age = 35.5 years) from two Houston-area community centers. Data were collected on household food security status using the 18-item USDA scale, demographic characteristics, and measured height, weight, body fat percentage, and waist circumference from children and mothers. Results: Sixty-five percent of children resided in a food insecure household, 31% of the children were obese in terms of %BF, and 24% were obese in terms of BMI. A greater percentage of food secure children were classified as obese in terms of %BF, BMI, and had an elevated waist circumference. A direct relationship was not observed between food insecurity and elevated waist circumference (OR = .08, p = .10); however, children living in food insecure households had 89% lower odds of having an elevated %BF (OR = 0.11, p \u3c .01), 93% lower odds of being obese (OR = 0.07, p \u3c .05), and 87% lower odds of being overweight/obese (OR = 0.13, p \u3c .05). Conclusions: In young children of Hispanic immigrants, food insecurity was related to healthier levels of %BF and BMI. Studies that track adiposity and weight status of children of Hispanic immigrants in relation to food insecurity over time are needed to further understand why food insecurity and obesity co-exist for some groups but not others

Cross-sectional Associations of Opiate Misuse/Opioid Use Disorder among Adults Experiencing Homelessness

The purpose of this manuscript is to determine the prevalence of opioid misuse/opioid use disorder (OUD) among adults experiencing homelessness and describe characteristics that account for significant variance in relation to opioid misuse in those who misuse and do not misuse opioids. From six homeless shelters in Oklahoma City, adults participated in a survey about their demographics, substance use, mental health, and physical health from July to August of 2016 (n = 569). For assessing substance use, participants responded about their opioid misuse and diagnosis of OUD, current smoking status, arrests due to drug possession or driving while intoxicated, and diagnosis with alcohol use disorder or another drug use disorder, excluding opiate use disorder. A cumulative score of mental health comorbidity was created based on affirmative responses for having been diagnosed with depression, post-traumatic stress disorder (PTSD), schizophrenia/schizoaffective disorder, bipolar disorder, or an anxiety disorder besides PTSD. For physical health, one item from the General Health Survey-Short Form assessed pain, one item from the Behavioral Risk Factor Surveillance Survey assessed health, and one item assessed history of concussion. Bivariate analyses and logistic regression models identified the association. Sixteen percent of participants reported having experienced opioid misuse/been diagnosed with OUD. Substance use behaviors and physical health accounted for significant variance among those who misuse compared to those that do not misuse opioids. The most robust positive association of opioid misuse included: being white, being a current smoker, being diagnosed with another drug disorder, and having a concussion history. Additional research among the homeless population with a focus on concussion history as it relates to substance use and mental health comorbidity is needed

Diet Quality as a Mediator of the Relation between Income-to-Poverty Ratio and Overweight/Obesity among Adults: Moderating Effect of Sex

Poverty status influences obesity and dietary quality, and dietary quality influences obesity. How these relationships differ by sex is unclear. The current study aims were to 1) determine whether dietary quality mediates the relation between income-to-poverty ratio (IPR) and overweight/obesity (OV/OB) among men and women, separately, and 2) determine whether either of the mediated paths differs by sex. Four cycles of NHANES (2007-2014) were merged to obtain an unweighted study sample of 12,768 adults with complete data. Exposure variables included self-reported measures of IPR, Healthy Eating index (HEI) total score to measure diet quality, and sex. Direct assessment of height and weight was used to create OV/OB vs. normal weight categories of interest. A multiple-group moderated mediation model was conducted to evaluate the moderating effect of sex on the association between IPR and OV/OB through HEI. Covariates included age, race, marital status, education, employment, meeting physical activity recommendations, and daily sedentary time. A greater proportion of females experienced OV/OB, lower IPR, and higher HEI. The association between IPR and HEI did not differ by sex. Greater IPR was associated with lower odds of experiencing OV/OB for women and higher odds of experiencing OV/OB among men. For both males and females, HEI partially mediated the relationship between IPR and OV/OB (p \u3c .05). While efforts to improve dietary quality of all adults regardless of income and sex is needed, improving the dietary quality of higher income men may assist with reducing their experiences with OV/OB