Gaps in the Evidence on Population Interventions to Reduce Consumption of Sugars: A Review of Reviews

Kirkpatrick, S. I., Raffoul, A., Maynard, M., Lee, K. M., & Stapleton, J. (2018). Gaps in the Evidence on Population Interventions to Reduce Consumption of Sugars: A Review of Reviews. Nutrients, 10(8), 1036. https://doi.org/10.3390/nu10081036There is currently considerable attention directed to identifying promising interventions to reduce consumption of sugars among populations around the world. A review of systematic reviews was conducted to identify gaps in the evidence on such interventions. Medline, EMBASE CINAHL, and the Cochrane Database of Systematic Reviews were searched to identify systematic reviews published in English from January 2005 to May 2017 and considering research on interventions to reduce sugar intake. Twelve systematic reviews that considered price changes, interventions to alter the food available within specific environments, and health promotion and education programs were examined. Each of the identified reviews focused on sugar-sweetened beverages (SSBs). The existing literature provides some promising indications in terms of the potential of interventions to reduce SSB consumption among populations. However, a common thread is the limited scope of available evidence, combined with the heterogeneity of methods and measures used in existing studies, which limits conclusions that can be reached regarding the effectiveness of interventions. Reviewed studies typically had limited follow-up periods, making it difficult to assess the sustainability of effects. Further, there is a lack of studies that address the complex context within which interventions are implemented and evaluated, and little is known about the cost-effectiveness of interventions. Identified gaps speak to the need for a more holistic approach to sources of sugars beyond SSBs, consensus on measures and methods, attention to the implementation of interventions in relation to context, and careful monitoring to identify intended and unintended consequences.At the time that the work was undertaken, Sharon Kirkpatrick was supported by a Canadian Cancer Society Research Institute Capacity Development Award (grant #702855)

Food insecurity among University of Waterloo undergraduate students: Barriers, coping strategies, and perceived health and academic implications

Background: Food insecurity, which refers to uncertain or inadequate access to food due to financial constraints, represents a serious public health problem in Canada. Although post-secondary students may be vulnerable due to high tuition fees and related factors, relatively little is known about experiences of food insecurity among this population. Research aim and objectives: To gain a better understanding of the experience of food insecurity among University of Waterloo undergraduate students, including perceived barriers and facilitators to food security, the strategies used to manage shortages of food and money for food, perceptions regarding implications for health and academic achievement, and suggestions for improving food security for post-secondary students. Methods: A mixed methods design included semi-structured in-depth interviews complemented by demographic and health surveys. The adult items from the Household Food Security Survey Module were used to determine participants’ food security status. Students were recruited using flyers posted on campus and distributed at the Feds Student Food Bank. Eligible participants included undergraduate students who lived off campus and provided an indication of compromised food access based on inadequate finances in response to an online screening questionnaire (n=14). Study design and thematic analysis was informed by Layder’s (1998) adaptive theory and Alaimo’s (2005) conceptual model of food insecurity. Results: Students felt that their food security included both quantity and quality of food. Students experienced common elements, including a preoccupation with the food supply, timing of food shortages, qualitative food compromises, and a desire to be independent. Students encountered a variety of barriers to food access and healthy eating, such as the food environment, food literacy, and time. However, precarious financial situations contributed most prominently to students’ food insecurity. Students bought into the norm of the starving student lifestyle, whereby precarious finances, unhealthy eating, limited time, and stress over school were typical and commonplace. Students adopted a variety of coping strategies to manage their food supply, including accessing emergency food programs, finding free meals, food sharing, borrowing food or money for food, normalizing their situation, and demonstrating resiliency. Further, food insecurity was perceived to have a negative impact on their academic achievement and health and wellbeing. Conclusions: This study has begun to fill the gap in research on student food insecurity and its implications in Canada. These exploratory findings suggest that food insecurity among post-secondary students is a serious issue with critical implications. These findings add to the growing argument that Canadian financial support for post-secondary students is inadequate for the maintenance of food security during university. Future strategies must address the root financial causes of food insecurity among students in order to create effective, long-lasting change

Experiences of Food Insecurity Among Undergraduate Students: “You Can’t Starve Yourself Through School”

Canadian post-secondary students are vulnerable to food insecurity, yet lack of examination of this issue has prevented identification of policy and program solutions. This mixed-methods study aimed to characterize the experience of food insecurity among undergraduate students by eliciting barriers to food security, strategies used to manage food and money shortages, and perceived implications for health and academic achievement. Surveys and in-depth interviews were conducted with 14 students who demonstrated compromised financial access to food. Students normalized experiences of food insecurity as typical of post-secondary education but expressed anxiety and frustration with financial inaccessibility to healthy food, and described negative implications for their physical and mental health and their ability to perform well in school. Ongoing attempts to adapt or adjust to food insecurity had limited success. Findings highlight the need to challenge the “starving student” ideology, which normalizes the lack of access to healthy food during higher education.  Les étudiants de niveau postsecondaire canadiens sont vulnérables à l’insécurité alimentaire, pourtant ce problème esquive aux examens qui mèneraient aux politiques et programmes solutions. Cette étude aux méthodes mixtes tente de définir l’expérience des étudiants en situation d’insécurité alimentaire en suscitant ses entraves, les stratégies pour gérer les manques de nourriture et d›argent, et les impacts perçus sur la santé et la réussite académique. Des sondages et des entrevues ont été menés auprès de 14 étudiants en situation d’insécurité alimentaire. Pour eux, il s’agit d’une expérience normale propre à l›éducation. Mais quant à l’inaccessibilité à une saine alimentation, tous ont parlé d’anxiété et de frustration avec les barrières financières en plus des impacts négatifs sur leur état physique et sur leur performance en classe. Les tentatives courantes d’adaptation à l’insécurité alimentaire ont eu un succès limité. Les résultats démontrent la nécessité de critiquer l’idéologie de « l’étudiant famélique » qui normalise leur accès limité à une saine alimentation durant leurs études postsecondaire

Experiences of Food Insecurity Among Undergraduate Students: “You Can’t Starve Yourself Through School”

Canadian post-secondary students are vulnerable to food insecurity, yet lack of examination of this issue has prevented identification of policy and program solutions. This mixed-methods study aimed to characterize the experience of food insecurity among undergraduate students by eliciting barriers to food security, strategies used to manage food and money shortages, and perceived implications for health and academic achievement. Surveys and in-depth interviews were conducted with 14 students who demonstrated compromised financial access to food. Students normalized experiences of food insecurity as typical of post-secondary education but expressed anxiety and frustration with financial inaccessibility to healthy food, and described negative implications for their physical and mental health and their ability to perform well in school. Ongoing attempts to adapt or adjust to food insecurity had limited success. Findings highlight the need to challenge the “starving student” ideology, which normalizes the lack of access to healthy food during higher education.Les étudiants de niveau postsecondaire canadiens sont vulnérables à l’insécurité alimentaire, pourtant ce problème esquive aux examens qui mèneraient aux politiques et programmes solutions. Cette étude aux méthodes mixtes tente de définir l’expérience des étudiants en situation d’insécurité alimentaire en suscitant ses entraves, les stratégies pour gérer les manques de nourriture et d›argent, et les impacts perçus sur la santé et la réussite académique. Des sondages et des entrevues ont été menés auprès de 14 étudiants en situation d’insécurité alimentaire. Pour eux, il s’agit d’une expérience normale propre à l›éducation. Mais quant à l’inaccessibilité à une saine alimentation, tous ont parlé d’anxiété et de frustration avec les barrières financières en plus des impacts négatifs sur leur état physique et sur leur performance en classe. Les tentatives courantes d’adaptation à l’insécurité alimentaire ont eu un succès limité. Les résultats démontrent la nécessité de critiquer l’idéologie de « l’étudiant famélique » qui normalise leur accès limité à une saine alimentation durant leurs études postsecondaire

Food Insecurity and Mental Health among Females in High-Income Countries

Food insecurity is a persistent concern in high-income countries, and has been associated with poor mental health, particularly among females. We conducted a scoping review to characterize the state of the evidence on food insecurity and mental health among women in high-income countries. The research databases PubMed, EMBASE, and psycINFO were searched using keywords capturing food insecurity, mental health, and women. Thirty-nine articles (representing 31 unique studies/surveys) were identified. Three-quarters of the articles drew upon data from a version of the United States Department of Agriculture Household Food Security Survey Module. A range of mental health measures were used, most commonly to measure depression and depressive symptoms, but also anxiety and stress. Most research was cross-sectional and showed associations between depression and food insecurity; longitudinal analyses suggested bidirectional relationships (with food insecurity increasing the risk of depressive symptoms or diagnosis, or depression predicting food insecurity). Several articles focused on vulnerable subgroups, such as pregnant women and mothers, women at risk of homelessness, refugees, and those who had been exposed to violence or substance abuse. Overall, this review supports a link between food insecurity and mental health (and other factors, such as housing circumstances and exposure to violence) among women in high-income countries and underscores the need for comprehensive policies and programs that recognize complex links among public health challenges