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Nutrition and Vulnerable Groups
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Nutrition and Vulnerable Groups

A special issue of Nutrients (ISSN 2072-6643).

Deadline for manuscript submissions: closed (30 September 2018) | Viewed by 110303

Printed Edition Available!
A printed edition of this Special Issue is available here.

Special Issue Editors

Dr. Amanda Devine

E-Mail Website
Guest Editor
Edith Cowan Univerity, School of Medical and Health Sciences,Perth Western Australia
Interests: Food security; Gut health; Life course Nutrition; Food literacy & Nutrition education; Built food environment
Dr. Tanya Lawlis

E-Mail Website
Guest Editor
University of Canberra, School of Clinical Sciences, Canberra Australia
Interests: Food security; Food literacy & Nutrition education; Child and Teenage health; Interprofessional education

Special Issue Information

Dear Colleagues,

Food insecurity is a complex ‘wicked’ problem that results from a range of unstable and uncertain physical, social, cultural and economic factors that limits access to nutritious food. Globally, 800 million people are under-nourished, and around 2 billion are overweight/obese or have micronutrient deficiency. These populations are largely positioned in developing countries where disease burden is high and impacts health budgets and productivity. Similarly developed countries, cities and neighbourhoods are experiencing a greater emergence of vulnerable populations. This is in part explained by the change in the food production and manufacturing, the retraction in economic climates, the increase in food price, and in some regions reduced food availability and access.

Vulnerable groups include but are not limited to migrant populations, Indigenous people, elderly, pregnant women, those with disability, homeless, young children and youth. Poor nutrition at significant periods of growth and development and during life impact long term health outcomes increasing non-communicable disease prevalence, health cost and reducing economic productivity.

This issue, Nutrition and Vulnerable Groups draws together quantitative and qualitative publications that have attempted to address the challenges of nutrition for vulnerable groups and have considered the complexity of the problem, the need for locally-driven solutions and scalable solutions and policy implications. Original papers, review articles and intervention studies dealing with vulnerable groups and dietary considerations will be included.

Dr. Amanda Devine
Dr. Tanya Lawlis
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Nutrients is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Vulnerable groups 
  • Nutrition 
  • Food 
  • Emergency food relief
  • Food rescue 
  • Food assistance program 
  • Food insufficiency 
  • Malnutrition 
  • Obesity 
  • Micronutrient deficiency 
  • Food programs/food bank/food interventions 
  • Health impacts 
  • Economic impacts

Published Papers (19 papers)

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Editorial

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4 pages, 168 KiB  
Editorial
Nutrition and Vulnerable Groups
by Amanda Devine and Tanya Lawlis
Nutrients 2019, 11(5), 1066; https://doi.org/10.3390/nu11051066 - 14 May 2019
Cited by 14 | Viewed by 5332
Abstract
Food insecurity is a complex ‘wicked’ problem that results from a range of unstable and uncertain physical, social, cultural, and economic factors that limit access to nutritious food [...] Full article
(This article belongs to the Special Issue Nutrition and Vulnerable Groups)

Research

Jump to: Editorial

10 pages, 826 KiB  
Article
The Food Literacy Action Logic Model: A Tertiary Education Sector Innovative Strategy to Support the Charitable Food Sectors Need for Food Literacy Training
by Tanya Lawlis, Ros Sambell, Amanda Douglas-Watson, Sarah Belton and Amanda Devine
Nutrients 2019, 11(4), 837; https://doi.org/10.3390/nu11040837 - 12 Apr 2019
Cited by 9 | Viewed by 5110
Abstract
Food literacy is seen as a key component in improving the increasing levels of food insecurity. While responsibility for providing training falls on the charitable service organizations, they may not have the capacity to adequately reach those in need. This paper proposes a [...] Read more.
Food literacy is seen as a key component in improving the increasing levels of food insecurity. While responsibility for providing training falls on the charitable service organizations, they may not have the capacity to adequately reach those in need. This paper proposes a tertiary education - (university or higher education) led model to support the food literacy training needs of the food charity sector. A cross-sectional study comprised of online surveys and discussions investigated food services offered by Western Australia (WA) and Australian Capital Territory (ACT) agencies, food literacy training needs for staff, volunteers and clients, and challenges to delivering food literacy training programs. Purposive sampling was used, and ACT and WA charitable service originations (survey: ACT n = 23, WA n = 32; interviews: ACT n = 3, WA n = 2) were invited to participate. Findings suggest organizations had limited financial and human resources to address the gap in food literacy training. Nutrition, food budgeting, and food safety education was delivered to paid staff only with limited capacity for knowledge transfer to clients. The Food Literacy Action Logic Model, underpinned by a tertiary education engagement strategy, is proposed to support and build capacity for organizations to address training gaps and extend the reach of food literacy to this under-resourced sector. Full article
(This article belongs to the Special Issue Nutrition and Vulnerable Groups)
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14 pages, 258 KiB  
Article
Food-Insecure Household’s Self-Reported Perceptions of Food Labels, Product Attributes and Consumption Behaviours
by Lucy M. Butcher, Maria M. Ryan, Therese A. O’Sullivan, Johnny Lo and Amanda Devine
Nutrients 2019, 11(4), 828; https://doi.org/10.3390/nu11040828 - 12 Apr 2019
Cited by 15 | Viewed by 3952
Abstract
Dietary compromises related to food insecurity profoundly undermine health and constitute a serious public health issue, even in developed nations. The aim of this study was to explore the impact of food labelling and product attributes on the purchasing choices of food-insecure households [...] Read more.
Dietary compromises related to food insecurity profoundly undermine health and constitute a serious public health issue, even in developed nations. The aim of this study was to explore the impact of food labelling and product attributes on the purchasing choices of food-insecure households in Australia. An online survey containing 19 food choice and 28 purchasing behaviours questions was completed by 1056 adults responsible for household grocery shopping. The short form of the US Household Food Security Survey Module was used as the food security indicator. Multinomial logistic regression modelling was employed to analyse the survey data. Respondents were classified as having either high-marginal (63.4%, n = 670), low (19.8%, n = 209) or very low (16.8%, n = 177) food security. Respondents with low or very low food security status were less likely to self-report understanding the information on the back of packaging (p < 0.001), find information on food labels useful (p = 0.002) or be influenced by product nutrition information (p = 0.002). Convenience (p < 0.001), organic (p = 0.027) and supermarket-branded products (p < 0.001) were more likely to be rated as important by food-insecure respondents when compared to their food-secure counterparts. When asked to rate “how healthy” their diet was, high–marginal FS respondents were twice as likely describe their diet as healthy than very low FS respondents (p = 0.001). Full article
(This article belongs to the Special Issue Nutrition and Vulnerable Groups)
12 pages, 537 KiB  
Article
South West Food Community: A Place-Based Pilot Study to Understand the Food Security System
by Stephanie Louise Godrich, Jennifer Payet, Deborah Brealey, Melinda Edmunds, Melissa Stoneham and Amanda Devine
Nutrients 2019, 11(4), 738; https://doi.org/10.3390/nu11040738 - 29 Mar 2019
Cited by 6 | Viewed by 4233
Abstract
The objectives of this study were to: (i) Identify initiatives supporting healthy food availability, access and utilisation in the South West region of Western Australia (WA); and (ii) understand how they were functioning as a system to enhance community-level food security (FS). This [...] Read more.
The objectives of this study were to: (i) Identify initiatives supporting healthy food availability, access and utilisation in the South West region of Western Australia (WA); and (ii) understand how they were functioning as a system to enhance community-level food security (FS). This study used a novel approach; a Systemic Innovation Lab, to interview initiative leaders/stakeholders about their FS initiative. Initiative characteristics measured included those which were associated with creating the effective conditions for FS systems change. Information was uploaded to an innovative online tool, creating a ‘transition card’ (matrix) of initiatives and partnering organisations. Fifty-one participants reported on 52 initiatives. Initiatives were most likely to possess characteristics relating to reinforcing changes towards an enhanced way of working to address FS and creating disruption to the old way of working. The initiative characteristic that initiatives were least likely to possess related to identifying the different causal factors of FS, and working with other stakeholders on specific components of FS. The South West Food Community pilot project used a comprehensive yet defined approach to demonstrate the value of a place-based, co-design project. Participants and stakeholders could strengthen specific initiative characteristics to facilitate enhanced community-level FS. Full article
(This article belongs to the Special Issue Nutrition and Vulnerable Groups)
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12 pages, 261 KiB  
Article
Canadian Children from Food Insecure Households Experience Low Self-Esteem and Self-Efficacy for Healthy Lifestyle Choices
by Stephanie L. Godrich, Olivia K. Loewen, Rosanne Blanchet, Noreen Willows and Paul Veugelers
Nutrients 2019, 11(3), 675; https://doi.org/10.3390/nu11030675 - 21 Mar 2019
Cited by 14 | Viewed by 6222
Abstract
The objectives of this cross-sectional study were to: (i) determine whether there are differences in self-esteem and self-efficacy for healthy lifestyle choices between children living in food secure and food insecure households; and (ii) determine whether the association between household food insecurity (HFI), [...] Read more.
The objectives of this cross-sectional study were to: (i) determine whether there are differences in self-esteem and self-efficacy for healthy lifestyle choices between children living in food secure and food insecure households; and (ii) determine whether the association between household food insecurity (HFI), self-esteem and self-efficacy differs by gender. Survey responses of 5281 fifth-grade students (10 and 11 years of age) participating in the Canadian Children’s Lifestyle and School Performance Study II were analyzed using logistic and linear regression. HFI status was determined by the six-item short-form Household Food Security Survey Module (HFSSM). Students from food insecure households had significantly higher odds of low self-esteem, and significantly lower scores for global self-efficacy to make healthy choices, compared to students from food secure households. These associations were stronger for girls than for boys and appeared independent of parental educational attainment. Household income appeared to be the essential underlying determinant of the associations of food insecurity with self-esteem and self-efficacy. Upstream social policies such as improving the household income of low-income residents will reduce food insecurity and potentially improve self-esteem and self-efficacy for healthy choices among children. This may improve health and learning, and in the long term, job opportunities and household earnings. Full article
(This article belongs to the Special Issue Nutrition and Vulnerable Groups)
13 pages, 592 KiB  
Article
Socio-Demographic Factors and Body Image Perception Are Associated with BMI-For-Age among Children Living in Welfare Homes in Selangor, Malaysia
by Nur Nabilla A Rahim, Yit Siew Chin and Norhasmah Sulaiman
Nutrients 2019, 11(1), 142; https://doi.org/10.3390/nu11010142 - 11 Jan 2019
Cited by 9 | Viewed by 6011
Abstract
Considering the double burden of malnutrition in Malaysia, data on malnourished children living in welfare homes are limited. This study aimed to determine the body weight status of children living in welfare homes and its associated factors. A total of 307 children aged [...] Read more.
Considering the double burden of malnutrition in Malaysia, data on malnourished children living in welfare homes are limited. This study aimed to determine the body weight status of children living in welfare homes and its associated factors. A total of 307 children aged 7–17 years old living in 15 selected welfare homes completed a standardized questionnaire, and their body weight and height were measured by trained researchers. There were 54.4% orphans, 23.8% abandoned children, and 21.8% children from problematic families. There were 51.5% boys and 48.5% girls; 52.4% were Malays, followed by 31.3% Indians, 12.7% Chinese, and 3.6% from other ethnic groups. The prevalence of overweight and obesity (23.1%) was higher than the prevalence of thinness (8.5%). In bivariate analyses, socio-demographic factors of age (p = 0.003), sex (p = 0.0001), ethnicity (p = 0.001), and welfare home enrollment status (p = 0.003), and psychological factors of self-esteem (p = 0.003), body shape dissatisfaction (p = 0.0001), and underestimation of body weight status (p = 0.002), were significantly associated with body mass index (BMI)-for-age. In the multiple linear regression analysis, children who were either Malays (β = 0.492) or Chinese (β = 0.678), with a status of being abandoned (β = 0.409), with body shape dissatisfaction (β = 0.457), and underestimated body weight status (β = 0.628) significantly explained 39.7% of the variances in higher BMI-for-age (F = 39.550; p < 0.05). Besides socio-demographic background, the current findings emphasized the importance of incorporating body image perception in an obesity prevention intervention program in welfare homes. Full article
(This article belongs to the Special Issue Nutrition and Vulnerable Groups)
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26 pages, 1979 KiB  
Article
Does Village Chicken-Keeping Contribute to Young Children’s Diets and Growth? A Longitudinal Observational Study in Rural Tanzania
by Julia De Bruyn, Peter C. Thomson, Ian Darnton-Hill, Brigitte Bagnol, Wende Maulaga and Robyn G. Alders
Nutrients 2018, 10(11), 1799; https://doi.org/10.3390/nu10111799 - 19 Nov 2018
Cited by 21 | Viewed by 5581
Abstract
There is substantial current interest in linkages between livestock-keeping and human nutrition in resource-poor settings. These may include benefits of improved diet quality, through animal-source food consumption and nutritious food purchases using livestock-derived income, and hazards of infectious disease or environmental enteric dysfunction [...] Read more.
There is substantial current interest in linkages between livestock-keeping and human nutrition in resource-poor settings. These may include benefits of improved diet quality, through animal-source food consumption and nutritious food purchases using livestock-derived income, and hazards of infectious disease or environmental enteric dysfunction associated with exposure to livestock feces. Particular concerns center on free-roaming chickens, given their proximity to children in rural settings, but findings to date have been inconclusive. This longitudinal study of 503 households with a child under 24 months at enrolment was conducted in villages of Manyoni District, Tanzania between May 2014, and May 2016. Questionnaires encompassed demographic characteristics, assets, livestock ownership, chicken housing practices, maternal education, water and sanitation, and dietary diversity. Twice-monthly household visits provided information on chicken numbers, breastfeeding and child diarrhea, and anthropometry was collected six-monthly. Multivariable mixed model analyses evaluated associations between demographic, socioeconomic and livestock-associated variables and (a) maternal and child diets, (b) children’s height-for-age and (c) children’s diarrhea frequency. Alongside modest contributions of chicken-keeping to some improved dietary outcomes, this study importantly (and of substantial practical significance if confirmed) found no indication of a heightened risk of stunting or greater frequency of diarrhea being associated with chicken-keeping or the practice of keeping chickens within human dwellings overnight. Full article
(This article belongs to the Special Issue Nutrition and Vulnerable Groups)
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13 pages, 234 KiB  
Article
Strategies to Address the Complex Challenge of Improving Regional and Remote Children’s Fruit and Vegetable Consumption
by Stephanie L. Godrich, Christina R. Davies, Jill Darby and Amanda Devine
Nutrients 2018, 10(11), 1603; https://doi.org/10.3390/nu10111603 - 01 Nov 2018
Cited by 8 | Viewed by 5155
Abstract
Fruit and vegetables (F&V) are imperative for good health, yet less than one per cent of Australian children consume these food groups in sufficient quantities. As guided by Social Cognitive Theory (SCT), this paper aimed to: (i) understand key informant perspectives of the [...] Read more.
Fruit and vegetables (F&V) are imperative for good health, yet less than one per cent of Australian children consume these food groups in sufficient quantities. As guided by Social Cognitive Theory (SCT), this paper aimed to: (i) understand key informant perspectives of the amount, types and quality of F&V consumed by rural and remote Western Australian (WA) children; and, (ii) determine strategies that could increase F&V consumption among rural and remote WA children. This qualitative study included 20 semi-structured interviews with health, school/youth and food supply workers, focusing on topics including: quantity and type of F&V consumed and strategies to increase children’s consumption. A thematic analysis was conducted using NVivo qualitative data analysis software (Version 10, 2014. QSR International Pty Ltd., Doncaster, Victoria, Australia). Key informants reported children consumed energy-dense nutrient-poor foods in place of F&V. Strategy themes included: using relevant motivators for children to increase their preference for F&V (i.e., gaming approach, SCT construct of ‘expectations’); empowering community-driven initiatives (i.e., kitchen gardens, SCT construct of ‘environment’); increasing food literacy across settings (i.e., food literacy skills, SCT construct of ‘behavioural capacity’); developing salient messages and cooking tips that resonate with parents (i.e., parent newsletters, SCT construct of ‘self-control’); increasing F&V availability, safety, and convenience (i.e., school provision); and, considering the impact of role models that extend beyond the family (i.e., relatable role models, SCT construct of ‘observational learning’). Overall, a comprehensive strategy that incorporates relevant motivators for children and families, supports local initiatives, reinforces the range of role models that are involved with children and creates healthier environments, is required to increase F&V consumption among children. Full article
(This article belongs to the Special Issue Nutrition and Vulnerable Groups)
14 pages, 693 KiB  
Article
The Identification of the Factors Related to Household Food Insecurity among Indigenous People (Orang Asli) in Peninsular Malaysia under Traditional Food Systems
by Leh Shii Law, Sulaiman Norhasmah, Wan Ying Gan, Adznam Siti Nur’Asyura and Mohd Taib Mohd Nasir
Nutrients 2018, 10(10), 1455; https://doi.org/10.3390/nu10101455 - 08 Oct 2018
Cited by 21 | Viewed by 6283
Abstract
Over the course of 16 years, a high percentage of Orang Asli (OA) households in Malaysia has been found to be burdened with food insecurity. Therefore, a study was conducted to improve the understanding of the challenges faced by the OA in Peninsular [...] Read more.
Over the course of 16 years, a high percentage of Orang Asli (OA) households in Malaysia has been found to be burdened with food insecurity. Therefore, a study was conducted to improve the understanding of the challenges faced by the OA in Peninsular Malaysia to achieve food security under traditional food systems. In this study, in-depth interview sessions, which were assisted by an interview protocol, were conducted with 61 OA women from nine villages that were selected purposefully across three states (Kelantan, Pahang, and Perak) in Peninsular Malaysia. Furthermore, thematic analysis was performed during data analysis. As a result, four themes were identified, namely (i) the failure in agriculture (sub-themes: threats from wild animals and insufficient land supply), (ii) ineffectiveness of traditional food-seeking activities (sub-themes: exhausting, tiring, dangerous, and time-consuming journey for food-seeking activities, depletion of natural commodities, reduced demands of natural commodities, and lack of equipment), (iii) weather (sub-themes: rainy and dry seasons), and (iv) water issues (subthemes: continuity of water supply and cleanliness of water). The identified modifiable factors of this issue should be incorporated into future schemes of food security intervention in order to efficiently manage the food shortage among the OA. Full article
(This article belongs to the Special Issue Nutrition and Vulnerable Groups)
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18 pages, 326 KiB  
Article
Increased Adiposity as a Potential Risk Factor for Lower Academic Performance: A Cross-Sectional Study in Chilean Adolescents from Low-to-Middle Socioeconomic Background
by Paulina Correa-Burrows, Yanina Rodriguez, Estela Blanco, Sheila Gahagan and Raquel Burrows
Nutrients 2018, 10(9), 1133; https://doi.org/10.3390/nu10091133 - 21 Aug 2018
Cited by 11 | Viewed by 3874
Abstract
We explored the association between excess body fat and academic performance in high school students from Santiago, Chile. In 632 16-year-olds (51% males) from low-to-middle socioeconomic status (SES), height, weight, and waist circumference were measured. Body-mass index (BMI) and BMI for age and [...] Read more.
We explored the association between excess body fat and academic performance in high school students from Santiago, Chile. In 632 16-year-olds (51% males) from low-to-middle socioeconomic status (SES), height, weight, and waist circumference were measured. Body-mass index (BMI) and BMI for age and sex were calculated. Weight status was evaluated with 2007 World Health Organization (WHO) references. Abdominal obesity was diagnosed with International Diabetes Federation (IDF) references. Total fat mass (TFM) was measured with dual-energy X-ray absorptiometry (DXA). TFM values ≥25% in males and ≥35% in females were considered high adiposity. School grades were obtained from administrative records. Analysis of covariance examined the association of fatness measures with academic performance, accounting for the effect of diet and physical activity, and controlling SES background and educational confounders. We found that: (1) having obesity, abdominal obesity, or high adiposity was associated with lower school performance alone or in combination with unhealthy dietary habits or reduced time allocation for exercise; (2) high adiposity and abdominal obesity were more clearly related with lower school grades compared to obesity; (3) the association of increased fatness with lower school grades was more salient in males compared to females. Full article
(This article belongs to the Special Issue Nutrition and Vulnerable Groups)
11 pages, 274 KiB  
Article
Consumption of Fruits and Vegetables by Low-Income Brazilian Undergraduate Students: A Cross-Sectional Study
by Ygraine Hartmann, Raquel B. A. Botelho, Rita De Cássia C. de A. Akutsu and Renata Puppin Zandonadi
Nutrients 2018, 10(8), 1121; https://doi.org/10.3390/nu10081121 - 19 Aug 2018
Cited by 14 | Viewed by 4030
Abstract
Objective: This study aimed to evaluate the consumption of fruits and vegetables (FV) by low-income students participating in the Brazilian Student Assistance Program. Methods: For three days, we measured participants’ consumption through direct observation of food intake at the University Restaurant (UR) and [...] Read more.
Objective: This study aimed to evaluate the consumption of fruits and vegetables (FV) by low-income students participating in the Brazilian Student Assistance Program. Methods: For three days, we measured participants’ consumption through direct observation of food intake at the University Restaurant (UR) and 24-h recall outside the restaurant. The 174 undergraduates were divided into two groups to obtain data on FV intake at the weekend (Sunday) and two days of the week. Group 1 included low-income undergraduates who received their meals for free, and Group 2 included students who paid for their meals at the UR. Results: Both groups presented a very low consumption of FV. On the weekend, Group 1 consumption was equal to Group 2, but it was higher than Group 2 on weekdays, demonstrating how important the UR is for this population. The lowest contribution of the UR to the daily consumption of FV was 59%, reaching a percentage of 87.27%. Fruit supply in the restaurant menu may have positively influenced this consumption. Conclusions: The consumption of FV varied according to the menu offered at the UR. The UR should be a space to promote healthy eating habits including more FV in its menus. Full article
(This article belongs to the Special Issue Nutrition and Vulnerable Groups)
10 pages, 377 KiB  
Article
Metabolic Syndrome among Refugee Women from the West Bank, Palestine: A Cross-Sectional Study
by Salwa G. Massad, Mohammed Khalili, Wahida Karmally, Marwah Abdalla, Umaiyeh Khammash, Gebre-Medhin Mehari and Richard J. Deckelbaum
Nutrients 2018, 10(8), 1118; https://doi.org/10.3390/nu10081118 - 18 Aug 2018
Cited by 9 | Viewed by 4263
Abstract
This study was carried out among Palestinian refugee women in the West Bank to provide data on the prevalence of metabolic syndrome (MetS) and its correlates. Data were obtained from a cross-sectional study of 1694 randomly selected refugee women from the United Nations [...] Read more.
This study was carried out among Palestinian refugee women in the West Bank to provide data on the prevalence of metabolic syndrome (MetS) and its correlates. Data were obtained from a cross-sectional study of 1694 randomly selected refugee women from the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) health centers throughout the West Bank during June and July 2010. In this cohort, 30% of the refugee women were overweight, 39% were obese, and 7% were extremely obese. Based on World Health Organization (WHO) criteria, the age-adjusted prevalence of MetS was 19.8%. The results of the binary logistic regression analysis indicated that older age and younger marital age were significantly associated with an increased likelihood of MetS in the women. The high prevalence of obesity and MetS mandates the implementation of national policies for its prevention, notably by initiating large-scale community intervention programs for 5.2 million refugees in Palestine, Jordan, Lebanon, and Syria, to tackle obesity and increase the age at marriage. Full article
(This article belongs to the Special Issue Nutrition and Vulnerable Groups)
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15 pages, 866 KiB  
Article
What Drives Food Insecurity in Western Australia? How the Perceptions of People at Risk Differ to Those of Stakeholders
by Lucy M. Butcher, Maria M. Ryan, Therese A. O’Sullivan, Johnny Lo and Amanda Devine
Nutrients 2018, 10(8), 1059; https://doi.org/10.3390/nu10081059 - 09 Aug 2018
Cited by 12 | Viewed by 4982
Abstract
Food insecurity is considered a “wicked” problem due to the highly complex and at times undefined casual factors. Although many stakeholders are working to address the problem, a possible divergence exists between their views on food insecurity and those of the people who [...] Read more.
Food insecurity is considered a “wicked” problem due to the highly complex and at times undefined casual factors. Although many stakeholders are working to address the problem, a possible divergence exists between their views on food insecurity and those of the people who are actually experiencing the problem. The purpose of this study was to investigate whether there was a difference between the opinions of those “at risk” and stakeholders. A total of seven focus groups (two stakeholder groups n = 10, five “at-risk” groups n = 34) and three interviews (stakeholders n = 3) were conducted to ascertain perceptions. Thematic analysis generated 329 (209 “at-risk” and 120 stakeholder) coded statements related to food insecurity drivers. Respondents were in agreement for the majority of factors, and limited income was considered the primary driver of food insecurity. However, there were notable deviations in the perceived importance of certain drivers, particularly around the price of food and the lack of food literacy. Differences in the perception of causes of food insecurity may in part be attributed to the varied role each group plays in working towards the resolution of the problem, either at the household or system level. Full article
(This article belongs to the Special Issue Nutrition and Vulnerable Groups)
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14 pages, 419 KiB  
Article
Best Practices and Innovative Solutions to Overcome Barriers to Delivering Policy, Systems and Environmental Changes in Rural Communities
by Lindsey Haynes-Maslow, Isabel Osborne and Stephanie B. Jilcott Pitts
Nutrients 2018, 10(8), 1012; https://doi.org/10.3390/nu10081012 - 03 Aug 2018
Cited by 27 | Viewed by 5421
Abstract
To better understand the barriers to implementing policy; systems; and environmental (PSE) change initiatives within Supplemental Nutrition Assistance Program-Education (SNAP-Ed) programming in U.S. rural communities; as well as strategies to overcome these barriers, this study identifies: (1) the types of nutrition-related PSE SNAP-Ed [...] Read more.
To better understand the barriers to implementing policy; systems; and environmental (PSE) change initiatives within Supplemental Nutrition Assistance Program-Education (SNAP-Ed) programming in U.S. rural communities; as well as strategies to overcome these barriers, this study identifies: (1) the types of nutrition-related PSE SNAP-Ed programming currently being implemented in rural communities; (2) barriers to implementing PSE in rural communities; and (3) common best practices and innovative solutions to overcoming SNAP-Ed PSE implementation barriers. This mixed-methods study included online surveys and interviews across fifteen states. Participants were eligible if they: (1) were SNAP-Ed staff that were intimately aware of facilitators and barriers to implementing programs, (2) implemented at least 50% of their programming in rural communities, and (3) worked in their role for at least 12 months. Sixty-five staff completed the online survey and 27 participated in interviews. Barriers to PSE included obtaining community buy-in, the need for relationship building, and PSE education. Facilitators included finding community champions; identifying early “wins” so that community members could easily see PSE benefits. Partnerships between SNAP-Ed programs and non-SNAP-Ed organizations are essential to implementing PSE. SNAP-Ed staff should get buy-in from local leaders before implementing PSE. Technical assistance for rural SNAP-Ed programs would be helpful in promoting PSE. Full article
(This article belongs to the Special Issue Nutrition and Vulnerable Groups)
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19 pages, 350 KiB  
Article
Impact of a Pilot School-Based Nutrition Intervention on Dietary Knowledge, Attitudes, Behavior and Nutritional Status of Syrian Refugee Children in the Bekaa, Lebanon
by Marwa Diab El Harake, Samer Kharroubi, Shadi K. Hamadeh and Lamis Jomaa
Nutrients 2018, 10(7), 913; https://doi.org/10.3390/nu10070913 - 17 Jul 2018
Cited by 48 | Viewed by 10709
Abstract
This study evaluated the impact of a 6-month school nutrition intervention on changes in dietary knowledge, attitude, behavior (KAB) and nutritional status of Syrian refugee children. A quasi-experimental design was followed; Syrian refuge children in grades 4 to 6 were recruited from three [...] Read more.
This study evaluated the impact of a 6-month school nutrition intervention on changes in dietary knowledge, attitude, behavior (KAB) and nutritional status of Syrian refugee children. A quasi-experimental design was followed; Syrian refuge children in grades 4 to 6 were recruited from three informal primary schools (two intervention and one control) located in the rural Bekaa region of Lebanon. The intervention consisted of two main components: classroom-based education sessions and provision of locally-prepared healthy snacks. Data on household socio-demographic characteristics, KAB, anthropometric measures and dietary intake of children were collected by trained field workers at baseline and post-intervention. Of the 296 school children enrolled, 203 (68.6%) completed post-intervention measures. Significant increases in dietary knowledge (β = 1.22, 95% CI: 0.54, 1.89), attitude (β = 0.69, 95% CI: 0.08, 1.30), and body mass index-for-age-z-scores (β = 0.25, 95% CI = 0.10, 0.41) were observed among intervention vs. control groups, adjusting for covariates (p < 0.05). Compared to the control, the intervention group had, on average, significantly larger increases in daily intakes of total energy, dietary fiber, protein, saturated fat, and several key micronutrients, p < 0.05. Findings suggest a positive impact of this school-based nutrition intervention on dietary knowledge, attitude, and nutritional status of Syrian refugee children. Further studies are needed to test the feasibility and long-term impact of scaling-up such interventions. Full article
(This article belongs to the Special Issue Nutrition and Vulnerable Groups)
10 pages, 250 KiB  
Article
Daily Dietary Intake Patterns Improve after Visiting a Food Pantry among Food-Insecure Rural Midwestern Adults
by Breanne N. Wright, Regan L. Bailey, Bruce A. Craig, Richard D. Mattes, Lacey McCormack, Suzanne Stluka, Lisa Franzen-Castle, Becky Henne, Donna Mehrle, Dan Remley and Heather A. Eicher-Miller
Nutrients 2018, 10(5), 583; https://doi.org/10.3390/nu10050583 - 09 May 2018
Cited by 35 | Viewed by 6582
Abstract
Emergency food pantries provide food at no cost to low-resource populations. The purpose of this study was to evaluate single-day dietary intake patterns before and after visiting a food pantry among food-secure and food-insecure pantry clients. This observational cohort study comprised a paired, [...] Read more.
Emergency food pantries provide food at no cost to low-resource populations. The purpose of this study was to evaluate single-day dietary intake patterns before and after visiting a food pantry among food-secure and food-insecure pantry clients. This observational cohort study comprised a paired, before-and-after design with a pantry visit as the intervention. Participants (n = 455) completed a demographic and food security assessment, and two 24-h dietary recalls. Adult food security was measured using the U.S. Household Food Security Survey Module. Dietary intake patterns were assessed using Automated Self-Administered 24-h Recall data and classified by Healthy Eating Index (HEI-2010) scores, dietary variety, number of eating occasions, and energy intake. Paired t-tests and Wilcoxon signed-rank tests compared outcomes before and after a pantry visit. Mean dietary variety increased after the pantry visit among both food-secure (p = 0.02) and food-insecure (p < 0.0001) pantry clients. Mean energy intake (p = 0.0003), number of eating occasions (p = 0.004), and HEI-2010 component scores for total fruit (p < 0.001) and whole fruit (p < 0.0003) increased among food-insecure pantry clients only. A pantry visit may improve dietary intake patterns, especially among food-insecure pantry clients. Full article
(This article belongs to the Special Issue Nutrition and Vulnerable Groups)
16 pages, 661 KiB  
Article
Household Food Insecurity as a Predictor of Stunted Children and Overweight/Obese Mothers (SCOWT) in Urban Indonesia
by Trias Mahmudiono, Triska Susila Nindya, Dini Ririn Andrias, Hario Megatsari and Richard R. Rosenkranz
Nutrients 2018, 10(5), 535; https://doi.org/10.3390/nu10050535 - 26 Apr 2018
Cited by 52 | Viewed by 7837
Abstract
(1) Background: The double burden of malnutrition has been increasing in countries experiencing the nutrition transition. This study aimed to determine the relationship between household food insecurity and the double burden of malnutrition, defined as within-household stunted child and an overweight/obese mother [...] Read more.
(1) Background: The double burden of malnutrition has been increasing in countries experiencing the nutrition transition. This study aimed to determine the relationship between household food insecurity and the double burden of malnutrition, defined as within-household stunted child and an overweight/obese mother (SCOWT). (2) Methods: A cross-sectional survey was conducted in the urban city of Surabaya, Indonesia in April and May 2015. (3) Results: The prevalence of child stunting in urban Surabaya was 36.4%, maternal overweight/obesity was 70.2%, and SCOWT was 24.7%. Although many households were food secure (42%), there were high proportions of mild (22.9%), moderate (15.3%) and severe (19.7%) food insecurity. In a multivariate logistic regression, the household food insecurity access scale (HFIAS) category significantly correlated with child stunting and SCOWT. Compared to food secure households, mildly food insecure households had the greatest odds of SCOWT (adjusted odds ratio (aOR) = 2.789; 95% confidence interval (CI) = 1.540–5.083), followed by moderately food insecure (aOR = 2.530; 95% CI = 1.286–4.980) and severely food insecure households (aOR = 2.045; 95% CI = 1.087–3.848). (4) Conclusions: These results support the hypothesis that the double burden of malnutrition is related to food insecurity, and the HFIAS category is a predictor of SCOWT. Full article
(This article belongs to the Special Issue Nutrition and Vulnerable Groups)
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8 pages, 559 KiB  
Article
Is What Low-Income Brazilians Are Eating in Popular Restaurants Contributing to Promote Their Health?
by Alinne De Paula Carrijo, Raquel Braz Assunção Botelho, Rita De Cássia Coelho de Almeida Akutsu and Renata Puppin Zandonadi
Nutrients 2018, 10(4), 414; https://doi.org/10.3390/nu10040414 - 27 Mar 2018
Cited by 22 | Viewed by 4111
Abstract
This study evaluates the healthfulness of the meals offered to and consumed by low-income Brazilians in Popular Restaurants (PR). It is a cross-sectional, exploratory study. The final sample includes 36 PRs, respecting the stratification criteria for each of the five Brazilian regions. To [...] Read more.
This study evaluates the healthfulness of the meals offered to and consumed by low-income Brazilians in Popular Restaurants (PR). It is a cross-sectional, exploratory study. The final sample includes 36 PRs, respecting the stratification criteria for each of the five Brazilian regions. To identify the quantity and quality of food consumption, consumers’ meals are evaluated. The sample calculation uses a minimum of 41 consumers in each PR. Consumption evaluation is carried out by weighing and direct observation of the meal that each consumer served to his plate. Each dish of the meals had its Technical preparation files (TPF) developed by observing the production and weighing all the ingredients. Evaluations of Energy density (ED), meal’s weight components and sodium composition are conducted. Plate’s composition is compared to “My plate” guidelines United States Department of Agriculture (USDA). The final sample includes 1771 low-income Brazilians consumers. The plate of PRs consumers is adequate only for the “protein group” in comparison to “My plate”. Rice and beans compose more than 50% of the plate’s weight, as expected, since it is a Brazilian habit of consumption at lunch. Thus, grains are the major group consumed by PRs consumers. The average ED for all PRs is 1.34 kcal/g. Regarding sodium content, rice and main courses presented the highest values and are classified as high, according to Food and Drug Administration (FDA). Concerning sodium, PRs are putting Brazilian low-income population at risk for chronic diseases. However, in general, PRs are good choices because they promote access to cheap and quality traditional Brazilian foods. Full article
(This article belongs to the Special Issue Nutrition and Vulnerable Groups)
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15 pages, 11220 KiB  
Article
Influence of Feeding Practices on Malnutrition in Haitian Infants and Young Children
by Belén Irarrázaval, Salesa Barja, Edson Bustos, Romel Doirsaint, Gloria Senethmm, María Paz Guzmán and Ricardo Uauy
Nutrients 2018, 10(3), 382; https://doi.org/10.3390/nu10030382 - 20 Mar 2018
Cited by 8 | Viewed by 7143
Abstract
Infant malnutrition remains an important cause of death and disability, and Haiti has the highest prevalence in the Americas. Therefore, preventive strategies are needed. Our aims were (1) To assess the prevalence of malnutrition among young children seen at a health center in [...] Read more.
Infant malnutrition remains an important cause of death and disability, and Haiti has the highest prevalence in the Americas. Therefore, preventive strategies are needed. Our aims were (1) To assess the prevalence of malnutrition among young children seen at a health center in Haiti; (2) Examine adherence to infant feeding practices recommended by the World Health Organization (WHO) and the association to nutritional status. This cross-sectional study recruited children from the Saint Espri Health Center in Port Au Prince in 2014. We recorded feeding practices, socio-demographic data, and anthropometric measurements (WHO-2006). We evaluated 278 infants and children younger than two years old, aged 8.08 ± 6.5 months, 53.2% female. 18.35% were underweight (weight/age <−2 SD); 13.31% stunted (length/age <−2 SD), and 13.67% had moderate or severe wasting (weight/length <−2 SD). Malnutrition was associated with male gender, older age, lower maternal education level, and greater numbers of siblings (Chi2, p < 0.05). Adherence to recommended breastfeeding practices was 11.8–97.9%, and to complementary feeding practices was 9.7–90.3%. Adherence was associated with a lower prevalence of malnutrition. Conclusion: Prevalence of infant and young child malnutrition in this population is high. Adherence to WHO-recommended feeding practices was associated with a better nutritional status. Full article
(This article belongs to the Special Issue Nutrition and Vulnerable Groups)
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