Nutrients

Research

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15 pages, 459 KiB

Open AccessArticle

Persistent Food Insecurity and Material Hardships: A Latent Class Analysis of Experiences among Venezuelan Refugees and Migrants in Urban Colombia

by Andrea L. Wirtz, Megan Stevenson, José Rafael Guillén, Jennifer Ortiz, Miguel Ángel Barriga Talero, Kathleen R. Page, Jhon Jairo López, Jhon Fredy Ramirez Correa, Damary Martínez Porras, Ricardo Luque Núñez, Julián Alfredo Fernández-Niño and Paul B. Spiegel

Nutrients 2024, 16(7), 1060; https://doi.org/10.3390/nu16071060 - 4 Apr 2024

Viewed by 1307

Abstract

The causes and conditions of displacement often increase the vulnerability of migrant and refugee populations to food insecurity, alongside other material hardships. We aimed to examine the multidimensional aspects and patterns of food insecurity and other material hardships in a cross-sectional sample of [...] Read more.

The causes and conditions of displacement often increase the vulnerability of migrant and refugee populations to food insecurity, alongside other material hardships. We aimed to examine the multidimensional aspects and patterns of food insecurity and other material hardships in a cross-sectional sample of 6221 Venezuelan refugees and migrants in urban Colombia using a latent class analysis. Using multinomial and logistic regression models, we investigated the demographic and migratory experiences associated with identified classes and how class membership is associated with multiple health outcomes among Venezuelan refugees and migrants, respectively. Approximately two thirds of the sample was comprised cisgender women, and the participants had a median age of 32 years (IQR: 26–41). Four heterogeneous classes of food insecurity and material hardships emerged: Class 1—low food insecurity and material hardship; Class 2—high food insecurity and material hardship; Class 3—high income hardship with insufficient food intake; and Class 4—income hardship with food affordability challenges. Class 2 reflected the most severe food insecurity and material hardships and had the highest class membership; Venezuelans with an irregular migration status were almost 1.5 times more likely to belong to this class. Food insecurity and material hardship class membership was independently associated with self-rated health, mental health symptoms, and recent violence victimization and marginally associated with infectious disease outcomes (laboratory-confirmed HIV and/or syphilis infection). Social safety nets, social protection, and other interventions that reduce and prevent material hardships and food insecurity among refugees and migrants, alongside the host community, may improve public health, support development, and reduce healthcare costs. In the long term, regularization and social policies for migrants aimed at enhancing refugees’ and migrants’ social and economic inclusion may contribute to improving food security in this population. Full article

(This article belongs to the Special Issue Nutrition Status in Vulnerable Groups)

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10 pages, 251 KiB

Open AccessArticle

Enhancing Elderly Nutrition: A Qualitative Evaluation of Menus in a Social Solidarity Institution in the North of Portugal

by Sandra Celina Fernandes Fonseca, Suzanne Carvalho Barroso and Maria Cristina Teixeira Santos

Nutrients 2024, 16(5), 753; https://doi.org/10.3390/nu16050753 - 6 Mar 2024

Viewed by 1365

Abstract

This work addresses the importance of food and nutrition in promoting the health of the elderly population, with a specific focus on the qualitative evaluation of menus provided by a social solidarity institution in Portugal. The aim of this study is to conduct [...] Read more.

This work addresses the importance of food and nutrition in promoting the health of the elderly population, with a specific focus on the qualitative evaluation of menus provided by a social solidarity institution in Portugal. The aim of this study is to conduct a qualitative evaluation of menus furnished by a social solidarity institution situated in the northern region of Portugal in order to prevent and/or treat malnutrition in the elderly. The methodology involves the evaluation of four weekly menus, totaling 28 complete daily menus for the elderly, using the “Avaliação Qualitativa de Ementas Destinadas a Idosos” (AQEDI) tool. This assessment tool comprises six domains: general items, soup, protein suppliers, carbohydrate suppliers, vegetable suppliers, and dessert, each consisting of various parameters. The findings reveal that all menus were classified as “acceptable,” with percentages ranging from 60.73% to 68.84%, and suggest that there exists room for improvement. This study emphasizes the necessity for coordinated efforts within the institution to enhance menu planning, taking into account both nutritional guidelines and sensory aspects of food. Effective coordination within the institution is crucial for maintaining positive aspects and rectifying inadequacies in menu planning. Full article

(This article belongs to the Special Issue Nutrition Status in Vulnerable Groups)

7 pages, 203 KiB

Open AccessCommunication

Food Insecurity Is High in a Multi-Site Cohort of Transgender Women Vulnerable to or Living with HIV in the Eastern and Southern United States: Baseline Findings from the LITE Cohort

by Dougie Zubizarreta, Andrea L. Wirtz, Elizabeth Humes, Erin E. Cooney, Meg Stevenson, Keri N. Althoff, Asa E. Radix, Tonia Poteat, Chris Beyrer, Andrew J. Wawrzyniak, Kenneth H. Mayer and Sari L. Reisner

Nutrients 2024, 16(5), 707; https://doi.org/10.3390/nu16050707 - 29 Feb 2024

Viewed by 785

Abstract

The prevalence and correlates of food insecurity—the unavailability of food and limited access to it—have not been adequately considered among transgender women (TW), particularly alongside other health-related conditions burdening this population, such as HIV infection. This study examined the prevalence and correlates of [...] Read more.

The prevalence and correlates of food insecurity—the unavailability of food and limited access to it—have not been adequately considered among transgender women (TW), particularly alongside other health-related conditions burdening this population, such as HIV infection. This study examined the prevalence and correlates of food insecurity among TW. Between 2018 and 2020, 1590 TW in the Eastern and Southern U.S. completed a multi-site baseline assessment (socio-behavioral survey and HIV testing). Descriptive statistics were calculated and multivariable Poisson models with robust error variance were used to estimate prevalence ratios and 95% confidence intervals for correlates of food insecurity (dichotomized as sometimes-to-always vs. seldom-to-never running out of food). Eighteen percent of TW were living with HIV and nearly half of participants (44%) reported food insecurity. Correlates of food insecurity included being Black, multiracial, or another race/ethnicity; having < college education, low income, unstable housing, and high anticipated discrimination; and a history of sex work and sexual violence (all p < 0.05). Food insecurity was highly prevalent among TW. Current programs to provide food support do not adequately meet the needs of TW. HIV pr evention and care programs may benefit from addressing food insecurity. Full article

(This article belongs to the Special Issue Nutrition Status in Vulnerable Groups)

16 pages, 610 KiB

Open AccessArticle

Cost and Affordability of Habitual and Recommended Diets in Welfare-Dependent Households in Australia

by Meron Lewis, Stephen Nash and Amanda J. Lee

Nutrients 2024, 16(5), 659; https://doi.org/10.3390/nu16050659 - 26 Feb 2024

Viewed by 1153

Abstract

It is crucial to ensure healthy diets are affordable in low socioeconomic groups, such as welfare-dependent households, who experience higher rates of diet-related disease than others. This study assessed the cost of habitual (unhealthy) and recommended (healthy) diets in six welfare-dependent and six [...] Read more.

It is crucial to ensure healthy diets are affordable in low socioeconomic groups, such as welfare-dependent households, who experience higher rates of diet-related disease than others. This study assessed the cost of habitual (unhealthy) and recommended (healthy) diets in six welfare-dependent and six other, comparable Australian households, using either popular branded products or the cheapest available alternatives. It also assessed diet affordability in welfare-dependent households, before and after modest increases in government welfare payments introduced in early September 2023. Results confirmed that recommended diets were less expensive than habitual diets in all households unless the cheapest available products were included. This strategy reduced habitual diet costs by 35–37% and recommended diet costs by 30–32%. The lower cost differential could aid perceptions that healthy foods are more expensive than unhealthy foods. In April 2023, 23–37% of the income of welfare-dependent households with children was required to purchase recommended diets; this reduced only to 20–35% in September 2023. Hence, the increases in welfare payments were insufficient to meaningfully improve the affordability of healthy diets in the most vulnerable Australians. In the current cost-of-living crisis, there is an urgent need for more welfare support to help purchase healthy diets. Monitoring of diet cost and affordability is also required. Full article

(This article belongs to the Special Issue Nutrition Status in Vulnerable Groups)

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17 pages, 1557 KiB

Open AccessArticle

Food Security and Health Outcomes following Gray Divorce

by Hang Zhao, Tatiana Andreyeva and Xiaohan Sun

Nutrients 2024, 16(5), 633; https://doi.org/10.3390/nu16050633 - 24 Feb 2024

Viewed by 857

Abstract

The study evaluates the immediate and long-term consequences of gray divorce (i.e., marital dissolution after age 50) for the food security, depression, and disability of older Americans. Staggered Difference-in-Difference models were fitted to a nationally representative longitudinal sample of adults aged ≥ 50 [...] Read more.

The study evaluates the immediate and long-term consequences of gray divorce (i.e., marital dissolution after age 50) for the food security, depression, and disability of older Americans. Staggered Difference-in-Difference models were fitted to a nationally representative longitudinal sample of adults aged ≥ 50 years from the Health and Retirement Study, 1998–2018. Food insecurity and disability increase in the year of gray divorce and remain significantly elevated for up to six years or more following the event, consistent with the chronic strain model of gray divorce. Gray divorce has particularly adverse consequences for the food security of older women, while no gender differences were observed for disability. Increasing trends in gray divorce have important negative implications for food security and health of older Americans, particularly women, who appear to be less prepared to financially withstand a marital collapse in older age. Targeted policies to provide nutrition assistance and support in reemployment might be necessary to reduce the burden of food insecurity in the wake of gray divorce among women. Full article

(This article belongs to the Special Issue Nutrition Status in Vulnerable Groups)

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12 pages, 529 KiB

Open AccessArticle

A Prospective Comparison of Standard and Modified Acute Malnutrition Treatment Protocols during COVID-19 in South Sudan

by Shannon Doocy, Sarah King, Sule Ismail, Eva Leidman, Heather Stobaugh and The Action Against Hunger/US Centers for Disease Control and Prevention Study Team

Nutrients 2023, 15(23), 4853; https://doi.org/10.3390/nu15234853 - 21 Nov 2023

Viewed by 970

Abstract

A non-randomized prospective cohort study was conducted in 2022 to compare recovery rate and length of stay (LoS) for acutely malnourished children treated under South Sudan’s standard Community Management of Acute Malnutrition (CMAM) protocol and a COVID-modified protocol. Children aged 6–59 months received [...] Read more.

A non-randomized prospective cohort study was conducted in 2022 to compare recovery rate and length of stay (LoS) for acutely malnourished children treated under South Sudan’s standard Community Management of Acute Malnutrition (CMAM) protocol and a COVID-modified protocol. Children aged 6–59 months received acute malnutrition (AM) treatment under the standard or modified protocol (mid-upper-arm circumference-only entry/exit criteria and simplified dosing). Primary (recovery rate and LoS) were compared for outpatient therapeutic (OTP) and therapeutic supplementary feeding programs (TSFP) using descriptive statistics and mixed-effects models. Children admitted to OTP under both protocols were similar in age and sex; children admitted to TSFP were significantly older under the modified protocol than the standard protocol. Shorter LoS and higher recovery rates were observed under the modified protocol for both OTP (recovery: 93.3% vs. 87.2%; LoS: 38.3 vs. 42.8 days) and TSFP (recovery: 79.8% vs. 72.7%; LoS: 54.0 vs. 61.9 days). After adjusting for site and child characteristics, neither differences in adjusted odds of recovery [OTP: 2.63; TSFP 1.80] nor LoS [OTP −10.0; TSFP −7.8] remained significant. Modified protocols for AM performed well. Adjusted models indicate similar treatment outcomes to the standard protocol. Adopting simplified protocols could be beneficial post-pandemic; however, recovery and relapse will need to be monitored. Full article

(This article belongs to the Special Issue Nutrition Status in Vulnerable Groups)

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14 pages, 1130 KiB

Open AccessArticle

Examining the Triple Burden of Malnutrition: Insights from a Community-Based Comprehensive Nutrition Survey among Indigenous Tribal Children (0–19 Years) in the Western Ghats Hills of India

by Abdul Jaleel, N. Arlappa, K. Sree Ramakrishna, P. V. Sunu, G. Jayalakshmi, G. Neeraja, D. Narasimhulu, T. Santhosh Kumar and Senthil B. Kumar

Nutrients 2023, 15(18), 3995; https://doi.org/10.3390/nu15183995 - 15 Sep 2023

Cited by 2 | Viewed by 2021

Abstract

This article presents findings from a community-based cross-sectional study conducted in Attappadi, Kerala, India, aimed at assessing the prevalence of the triple burden of malnutrition among indigenous children aged 0–19 years. Historically, the indigenous population in Attappadi has faced significant developmental challenges, [...] Read more.

This article presents findings from a community-based cross-sectional study conducted in Attappadi, Kerala, India, aimed at assessing the prevalence of the triple burden of malnutrition among indigenous children aged 0–19 years. Historically, the indigenous population in Attappadi has faced significant developmental challenges, including high rates of malnutrition, infant mortality, and neonatal mortality. This study revealed alarming rates of undernutrition among children aged 0–59 months, with 40.9% experiencing stunting, 27.4% wasting, and 48.3% being underweight. Adolescent girls also suffered from undernutrition, with 21% classified as underweight and 43.3% experiencing stunting. Surprisingly, overweight or obesity was identified as a nutritional problem, affecting 1.4% of children aged 0–59 months, 4.2% of children aged 5–9 years, and 10.5% of adolescent girls. Additionally, a distressing proportion of young children aged 12–59 months (91.2%) were anaemic, with 50% diagnosed specifically with iron deficiency anaemia (IDA). Nearly all adolescent girls (96.6%) were reportedly suffering from anaemia. Deficiencies in vitamin B12, vitamin D, folate, and vitamin-A were prevalent among 35%, 20%, 16%, and 12% of children aged 12–59 months, respectively. The study underscores the urgent need for comprehensive interventions to address this triple burden of malnutrition. Recommendations include promoting culturally appropriate local food-based solutions, establishing participatory and community-led systems for health and nutrition information dissemination, and strengthening the nutrition surveillance system through village-level health and nutrition workers. By adopting a holistic approach, these interventions can help improve the nutritional status and well-being of the indigenous tribal children in Attappadi. Full article

(This article belongs to the Special Issue Nutrition Status in Vulnerable Groups)

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12 pages, 469 KiB

Open AccessArticle

Gender Expression, Weight Status, and Risk of Experiencing Eating Disorders among Gender-Diverse Adults Assigned Male at Birth in Bangkok, Thailand

by Thanit Vinitchagoon, Waris Wongpipit and Phenphop Phansuea

Nutrients 2023, 15(17), 3700; https://doi.org/10.3390/nu15173700 - 24 Aug 2023

Viewed by 1537

Abstract

This study examines the association between gender expression, weight status, and the risk of experiencing eating disorders among gender-diverse adults assigned male at birth living in Bangkok, Thailand. Participants completed self-administered questionnaires to provide demographic data and anthropometric measures, and an Eating Attitude [...] Read more.

This study examines the association between gender expression, weight status, and the risk of experiencing eating disorders among gender-diverse adults assigned male at birth living in Bangkok, Thailand. Participants completed self-administered questionnaires to provide demographic data and anthropometric measures, and an Eating Attitude Test-26 (EAT-26) to determine the risk of experiencing eating disorders. The associations between gender expression, weight status, and the risk of experiencing eating disorders were analyzed using multivariable logistic regression models. No significant differences were observed in weight-related variables based on gender expression. Participants self-described as feminine/androgynous had lower odds of experiencing a high risk of eating disorders compared to those self-described as masculine (odds ratio (OR) = 0.49; 95% confidence interval (95% CI) = 0.27, 0.88). A higher body mass index (BMI) (OR = 1.07; 95% CI = 1.01, 1.14) and BMI discrepancy (OR = 1.13; 95% CI = 1.03, 1.24) were associated with higher odds of engaging in extreme weight-control behaviors. The risk of experiencing eating disorders among Thai gender-diverse adults assigned male at birth could differ across gender expression and weight status. Further research is needed to expand the understanding of these relationships and develop tailored intervention programs to mitigate the risk. Full article

(This article belongs to the Special Issue Nutrition Status in Vulnerable Groups)

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Review

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21 pages, 472 KiB

Open AccessReview

Effectiveness of Postnatal Maternal or Caregiver Interventions on Outcomes among Infants under Six Months with Growth Faltering: A Systematic Review

by Ritu Rana, Barkha Sirwani, Saranya Mohandas, Richard Kirubakaran, Shuby Puthussery, Natasha Lelijveld and Marko Kerac

Nutrients 2024, 16(6), 837; https://doi.org/10.3390/nu16060837 - 14 Mar 2024

Viewed by 1147

Abstract

The care of infants at risk of poor growth and development is a global priority. To inform new WHO guidelines update on prevention and management of growth faltering among infants under six months, we examined the effectiveness of postnatal maternal or caregiver interventions [...] Read more.

The care of infants at risk of poor growth and development is a global priority. To inform new WHO guidelines update on prevention and management of growth faltering among infants under six months, we examined the effectiveness of postnatal maternal or caregiver interventions on outcomes among infants between 0 and 6 months. We searched nine electronic databases from January 2000 to August 2021, included interventional studies, evaluated the quality of evidence for seven outcome domains (anthropometric recovery, child development, anthropometric outcomes, mortality, readmission, relapse, and non-response) and followed the GRADE approach for certainty of evidence. We identified thirteen studies with preterm and/or low birth weight infants assessing effects of breastfeeding counselling or education (n = 8), maternal nutrition supplementation (n = 2), mental health (n = 1), relaxation therapy (n = 1), and cash transfer (n = 1) interventions. The evidence from these studies had serious indirectness and high risk of bias. Evidence suggests breastfeeding counselling or education compared to standard care may increase infant weight at one month, weight at two months and length at one month; however, the evidence is very uncertain (very low quality). Maternal nutrition supplementation compared to standard care may not increase infant weight at 36 weeks postmenstrual age and may not reduce infant mortality by 36 weeks post-menstrual age (low quality). Evidence on the effectiveness of postnatal maternal or caregiver interventions on outcomes among infants under six months with growth faltering is limited and of ‘low’ to ‘very low’ quality. This emphasizes the urgent need for future research. The protocol was registered with PROSPERO (CRD42022309001). Full article

(This article belongs to the Special Issue Nutrition Status in Vulnerable Groups)

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