Experts focus on food insecurity and its far-reaching consequences, particularly in vulnerable populations

Philadelphia, September 25, 2019 - Food insecurity is a lack of consistent access to enough food for an active, healthy life, according to the US Department of Agriculture. The latest issue of the Journal of the Academy of Nutrition and Dietetics, published by Elsevier, focuses on food insecurity in vulnerable populations including children, youth, college students, and older adults; raises awareness of the consequences of food insecurity for health and wellbeing; and presents strategies for addressing this serious problem.

While hunger is a personal, physical sensation of discomfort, food insecurity refers to a lack of availability of nutritionally adequate and safe foods or the inability to acquire acceptable foods in socially acceptable ways.

"Food insecurity has serious consequences for health and wellbeing, which is why the Journal decided to devote an entire issue to this important and timely topic," explains Editor-in-Chief Linda Snetselaar, PhD, RDN, LD, FAND, Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, USA. This collection of articles contributes to understanding how and why food insecurity is associated with poor wellbeing in families and individuals across the life course. It focuses on food insecurity in vulnerable populations including children, youth, college students, and older adults; food banking and food pantries; and connections between food insecurity and other vulnerabilities in families and seniors.

Although the United States is a high-income country, about 12 percent of the US population experienced food insecurity in 2017, including approximately 30 percent of households with children headed by a single woman and 20 percent of households with children headed by a single man. Other vulnerable groups include college students, women living alone, men living alone, black non-Hispanic and Hispanic heads of households, and households with incomes below 185 percent of the federal poverty line. The consequences associated with food insecurity for adults and especially for children include inadequate intake of key nutrients, overweight in women and some girls, less physical activity, symptoms of depression and risk of suicide in adolescents, poor physical and mental health, behavioral difficulties, and delays in academic and social development in children.

"There are many questions to be answered about how and why food insecurity is associated with such pervasive consequences in families and children and other vulnerable groups such as seniors and how clinical, community and public health nutrition professionals can best help prevent these outcomes," notes Edward A. Frongillo, PhD, Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, SC, USA, who explores the scope of the problem and highlights the far-reaching consequences associated with food insecurity.

In this issue, key strategies identified for managing food insecurity in vulnerable populations include:

School-age children: A need for ongoing efforts to improve weekend access to nutritious foods during the summer months for children from food-insecure households.

Federal nutrition assistance programs, such as the National School Lunch Program (NSLP) and the School Breakfast Program, provide school-aged children from low-income households with meals or snacks at a free or reduced price. However, data indicate that food insecurity increased by 13 percent during summer months among NSLP program participants. Jiwoo Lee, PhD, RN, School of Nursing, University of Minnesota, Minneapolis, MN, USA, and colleagues analyzed data from a community-based obesity prevention trial in metropolitan Minnesota and found that 8-12-year-old children from food-insecure households reported less energy intake, fewer servings of whole fruits, and more sugar-sweetened beverages on a weekend day, but not a weekday, when compared with children from food-secure households.

College students: An improved understanding of what it means to experience food insecurity in higher education that can inform how universities support students' basic needs.

College students may find themselves experiencing food insecurity as a result of several factors, including insufficient resources to purchase food, lack of grocery stores on campus, inadequate transportation or cooking facilities, and lack of cooking skills. In a California study conducted by Cindy W. Leung, ScD, MPH, Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA, and colleagues, students discussed several themes related to the psychosocial effects of food insecurity: the stress of food insecurity interfering with daily life; a fear of disappointing family; resentment of students in more stable food and financial situations; an inability to develop meaningful social relationships; sadness from reflecting on food insecurity; feeling hopeless or undeserving of help; and frustration directed at the academic institution for not providing enough support. Students also explored how food insecurity affected their academic performance through physical manifestations of hunger and the mental trade-off between focusing on food and focusing on academics.

Older adults: Implications for dietitians, nutritionists, and health counselors about how to address various challenges encountered by low-income older adults.

Older adults are another vulnerable population. Seung Eun Jung, PhD, RD, Department of Human Nutrition and Hospitality Management, The University of Alabama, Tuscaloosa, AL, USA, and colleagues investigated the complex relationships between self-care capacity, depression, food security, and nutritional status among low-income older adults. They found that inability to afford food combined with limited ability to take care of oneself contribute to an increased self-report of depressive symptoms. This process appears to result in a less favorable nutritional health status among low-income older adults.

Food banking: Continuing the transformation with the charitable foods system towards nutrition-focused food banking.

Food banks in the US were initially conceptualized as a community resource for families in need of emergency food assistance, but the charitable food system increasingly serves low-income households on a routine basis, with an estimated 54 percent of clients accessing food assistance for six or more months a year. A sample of 30 food bank executive leaders representing a diverse selection of food banks across the US were interviewed between 2015 and 2017 about specific strategies to support nutrition-focused food banking by Marianna S. Wetherill, PhD, MPH, RDN-AP/LD, Hudson College of Public Health, University of Oklahoma Tulsa Schusterman Center, Tulsa, OK, USA and colleagues. They highlighted four major needs: building a healthier food inventory at the food bank; enhancing partner agency healthy food access, storage and distribution capacity; nutrition education outreach; and expanding community partnerships and intervention settings for healthy food distribution, including health care and schools. As one of the study participants commented, "If you're going to eliminate hunger, it takes more than just the food banks giving out food ... It takes drilling down to the root cause of hunger and the places where the vulnerable populations are going and providing them with manna-the food."

In conclusion Dr. Leung remarks: "Food insecurity is not a new concept, but it's one that has persisted over decades. The face of food insecurity has continued to change in recent years and so we continue to strive to address this with our research. There is a clear link between food insecurity and poor psychological and mental health and academic achievement among college students, and links with disorders such as obesity and diabetes in adults. We need to support and continue to develop Federal programs that could help to reduce food insecurity, such as help with employment opportunities and health insurance."

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