Abstract
Food insecurity acts as a chronic stressor independent of poverty. Food-insecure adults
may consume more highly palatable foods as a coping mechanism, leading to poorer diet
quality and increased risks of chronic disease over time. Using data from the 1999-2008
National Health and Nutrition Examination Surveys, this study aimed to examine the
cross-sectional differences in dietary intake and diet quality by household food security
among 8,129 lower-income adults (≤300% of the federal poverty level). Food insecurity
was assessed using the 18-item US Household Food Security Survey Module. Dietary intake
was assessed from 24-hour recalls and diet quality was measured using the Healthy
Eating Index-2005 and the Alternate Healthy Eating Index-2010. Relative mean differences
in dietary outcomes by household food security were estimated using linear regression
models, adjusting for sociodemographic characteristics. Lower-income food-insecure
adults reported higher consumption of some highly palatable foods, including high-fat
dairy products (P trend<0.0001) and salty snacks (P trend=0.01) compared with lower-income food-secure adults. Food insecurity was also
associated with more sugar-sweetened beverages (P trend=0.003); more red/processed meat (P trend=0.005); more nuts, seeds, and legumes (P trend=0.0006); fewer vegetables (P trend<0.0001); and fewer sweets and bakery desserts (P trend=0.0002). No differences were observed for intakes of total energy and macronutrients.
Food insecurity was significantly associated with lower Healthy Eating Index-2005
(P trend<0.0001) and Alternate Healthy Eating Index-2010 scores (P trend<0.0001). Despite no macronutrient differences, food insecurity was associated
with characteristics of poor diet quality known to increase chronic disease risk.
Keywords
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Biography
C. W. Leung is a postdoctoral scholar, Center for Health and Community, School of Medicine, University of California, San Francisco.
Biography
E. S. Epel is associate director, Center for Health and Community, School of Medicine, and associate professor in residence, Department of Psychiatry, University of California, San Francisco.
Biography
L. D. Ritchie is director and cooperative extension specialist, Nutrition Policy Institute, University of California, Berkeley, Division of Agriculture and Natural Resources.
Biography
P. B. Crawford is director, Dr Robert C. and Veronica Atkins Center for Weight and Health, University of California, Berkeley.
Biography
B. A. Laraia is an associate professor, School of Public Health, University of California, Berkeley.
Article info
Publication history
Published online: August 01, 2014
Accepted:
June 12,
2014
Footnotes
STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors.
Supplementary materials: Tables 5 and 6 are available at www.andjrnl.org
FUNDING/SUPPORT C. W. Leung was supported by grant no. 142691 from the University of California Multicampus Research Program and Initiative.
Identification
Copyright
© 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.
