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. 2019 Oct;119(10):1676-1686.
doi: 10.1016/j.jand.2018.10.011. Epub 2018 Dec 20.

The Association between Food Insecurity and Diet Quality Varies by Race/Ethnicity: An Analysis of National Health and Nutrition Examination Survey 2011-2014 Results

Cindy W Leung, June M Tester

The Association between Food Insecurity and Diet Quality Varies by Race/Ethnicity: An Analysis of National Health and Nutrition Examination Survey 2011-2014 Results

Cindy W Leung et al. J Acad Nutr Diet. 2019 Oct.

Abstract

Background: Food insecurity is believed to influence the quality and quantity of foods consumed; however, studies examining food insecurity and diet quality have been inconclusive and few studies have explored variability in these associations by sex and race/ethnicity.

Objective: This study examined associations between food insecurity and diet quality, and variations by sex and race/ethnicity.

Design: Cross-sectional analysis of data from the 2011-2014 National Health and Nutrition Examination Surveys.

Participants: The study population was composed of 4,393 adults (aged 20 to 65 years) with family incomes ≤300% of the federal poverty level with complete data on household food security and dietary intake via two 24-hour dietary recalls.

Main outcome measures: Diet quality was assessed using the Healthy Eating Index-2015.

Statistical analyses performed: Associations between food insecurity and Healthy Eating Index-2015 total and component scores were examined using linear regression models and generalized linear models. Models adjusted for sociodemographic and health covariates.

Results: Compared with food-secure adults, food-insecure adults reported a 2.22-unit lower Healthy Eating Index-2015 score (95% CI -3.35 to -1.08). This association was most pronounced among non-Hispanic whites and adults of Asian or other races/ethnicities. There were no associations among non-Hispanic black or Hispanic adults, and no differences by sex. Among non-Hispanic whites, food insecurity was associated with lower scores for total protein foods, seafood and plant proteins, and added sugar. Among Asians, food insecurity was associated with lower scores for whole fruit.

Conclusions: Food insecurity was associated with lower diet quality primarily among non-Hispanic whites; Asians; and other adults, a group composed of American Indian or Alaska Natives, Native Hawaiian or Other Pacific Islanders, and multiracial adults. Further research is needed to better understand the nature of this association among understudied racial/ethnic groups.

Keywords: Diet quality; Food insecurity; National Health and Nutrition Examination Surveys; Race/ethnicity.

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Conflict of interest statement

Conflicts of interest: No conflicts of interest.

Figures

Figure 1a:
Figure 1a:
Adjusted mean Healthy Eating Index (HEI)-2015 total scores by sex of 4,393 adults – NHANES 2011–2014.
Figure 1b:
Figure 1b:
Adjusted mean Healthy Eating Index (HEI)-2015 total scores by race/ethnicity of 4,393 adults – NHANES 2011–2014
See this image and copyright information in PMC

References

    1. Hamilton WL, Cook JT, Thompson WW, et al. Household Food Security in the United States in 1995: Technical Report of the Food Security Measurement Project: Food and Consumer Service, U.S. Department of Agriculture; 1997.
    1. Coleman-Jensen A, Rabbitt MP, Gregory CA, Singh A. Household Food Security in the United States in 2017, ERR-256: U.S. Department of Agriculture, Economic Research Service; 2018. 290
    1. USDA ERS - Definitions of Food Security. Food Security in the U.S. Vol 2018: 291 Economic Research Service, U.S. Department of Agriculture; 2017. https://www.ers.usda.gov/topics/food-nutrition-assistance/food-security-.... Published 2017. Revised September 5, 2018. Accessed February 10, 2018.
    1. Hanson KL, Connor LM. Food insecurity and dietary quality in US adults and children: a systematic review. Am J Clin Nutr 2014;100:684–692. - PubMed
    1. Basiotis PP, Lino M. Food Insufficiency and Prevalence of Overweight among Adult Women. Fam Econ Rev 2003;15:55–57.

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