Advertisement

Position of the Academy of Nutrition and Dietetics: Food Insecurity in the United States

Published:November 21, 2017DOI:https://doi.org/10.1016/j.jand.2017.09.027

      Abstract

      It is the position of the Academy of Nutrition and Dietetics that systematic and sustained action is needed to achieve food and nutrition security in the United States. To achieve food security, effective interventions are needed, along with adequate funding for, and increased utilization of, food and nutrition assistance programs; inclusion of nutrition education in such programs; strategies to support individual and household economic stability; and research to measure impact on food insecurity- and health-related outcomes. Millions of individuals living in the United States experience food insecurity. Negative nutritional and non-nutritional outcomes are associated with food insecurity across the lifespan, including substandard academic achievement, inadequate intake of key nutrients, increased risk for chronic disease, and poor psychological and cognitive functioning. Registered dietitian nutritionists and nutrition and dietetics technicians, registered, play key roles in addressing food insecurity and are uniquely positioned to make valuable contributions through competent and collaborative practice, provision of comprehensive food and nutrition education and training, innovative research related to all aspects of food insecurity, and advocacy efforts at the local, state, regional, and national levels.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of the Academy of Nutrition and Dietetics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Anderson S.A.
        Core indicators of nutritional state for difficult-to-sample populations.
        J Nutr. 1990; 120: 1559-1600
      1. US Department of Agriculture, Economic Research Service. Food security in the US: Overview. https://www.ers.usda.gov/topics/food-nutrition-assistance/food-security-in-the-us/. Updated June 28, 2017. Accessed August 8, 2017.

      2. Coleman-Jensen A, Rabbitt MP, Gregory CA, Singh A. Household food insecurity in the United States in 2016 [ERR-237]. Economic Research Service website. https://www.ers.usda.gov/publications/pub-details?pubid=84972. Published September 2017. Accessed September 11, 2017.

      3. US Department of Health and Human Services. Coverage to care. https://www.hhs.gov/healthcare/coverage-to-care/index.html. Reviewed January 31, 2017. Accessed September 6, 2017.

      4. Centers for Disease Control and Prevention. CDC Community Health Improvement Navigator. https://www.cdc.gov/chinav/. Updated August 19, 2015. Accessed August 8, 2017.

        • US Department of the Treasury
        Patient Protection and Affordable Care Act of 2010, Final Regulations.
        Fed Reg. 2014; 79
      5. US Department of Health and Human Services, Office of Disease Prevention and Health Promotion. Healthy People 2020. https://www.healthypeople.gov/. Updated August 7, 2017. Accessed August 8, 2017.

      6. US Department of Health and Human Services, Office of Disease Prevention and Health Promotion. 2015-2020 Dietary Guidelines for Americans. https://health.gov/dietaryguidelines/2015/guidelines/. Published December 2015. Accessed August 7, 2017.

      7. Dietary Guidelines Advisory Committee. Scientific Report of the 2015 Dietary Guidelines Advisory Committee. https://health.gov/dietaryguidelines/2015-scientific-report/. Published February 2015. Accessed August 8, 2017.

      8. Academy of Nutrition and Dietetics. Report to the House of Delegates (HOD): Food and Nutrition Security Task Force 2014. http://www.eatrightpro.org/∼/media/eatrightpro%20files/leadership/hod/mega%20issues/food-and-nutrition-security-report-action-plan.ashx. Approved May 2, 2014. Accessed August 8, 2017.

        • Academy of Nutrition and Dietetics
        Position of the Academy of Nutrition and Dietetics: Food and water safety.
        J Acad Nutr Diet. 2014; 114: 1819-1829
        • Academy of Nutrition and Dietetics
        Position of the Academy of Nutrition and Dietetics: Nutrition security in developing nations: Sustainable food, water, and health.
        J Acad Nutr Diet. 2013; 113: 581-595
      9. Academy of Nutrition and Dietetics. Position papers. http://www.eatrightpro.org/resources/practice/position-and-practice-papers/position-papers. Accessed August 8, 2017.

      10. US Department of Agriculture, Economic Research Service. Definitions of food security. https://www.ers.usda.gov/topics/food-nutrition-assistance/food-security-in-the-us/definitions-of-food-security/. Updated October 4, 2016. Accessed August 8, 2017.

        • Academy of Nutrition and Dietetics
        Position of the Academy of Nutrition and Dietetics: Food and nutrition for older adults: Promoting health and wellness.
        J Acad Nutr Diet. 2012; 112: 1255-1277
        • American Dietetic Association
        Position of the American Dietetics Association: Food and nutrition for older adults: Food and nutrition programs for community-residing older adults.
        J Am Diet Assoc. 2010; 110: 463-472
      11. Weinfield NS, Mills G, Borger C, et al. Hunger in America 2014: National report. Feeding America website. http://help.feedingamerica.org/HungerInAmerica/hunger-in-america-2014-full-report.pdf. Published August 2014. Accessed August 7, 2017.

      12. The United States Conference of Mayors. The United States Conference of Mayors’ Report on Hunger and Homelessness: A status report on hunger and homelessness in America’s cities. https://endhomelessness.atavist.com/mayorsreport2016. Published December 2016. Accessed August 8, 2017.

      13. Sawhill IV, Joo N. The fed as poverty fighter. The Brookings Institute website. https://www.brookings.edu/blog/social-mobility-memos/2015/09/15/the-fed-as-poverty-fighter/. Published September 15, 2015. Accessed September 11, 2017.

      14. US Department of Agriculture, Economic Research Service. Frequency of food insecurity. https://www.ers.usda.gov/topics/food-nutrition-assistance/food-security-in-the-us/frequency-of-food-insecurity/. Updated October 4, 2016. Accessed August 8, 2017.

        • Seligman H.K.
        • Schillinger D.
        Hunger and socioeconomic disparities in chronic disease.
        N Engl J Med. 2010; 363: 6-9
      15. Nord M, Coleman-Jensen A, Gregory C. Prevalence of U.S. food insecurity is related to changes in unemployment, inflation, and the price of food. Economic Research Service website. https://www.ers.usda.gov/publications/pub-details/?pubid=45216. Published June 2014. Accessed September 11, 2017.

        • Rose D.
        Economic determinants and dietary consequences of food insecurity in the United States.
        J Nutr. 1999; 129: 517S-520S
      16. Tuttle CJ, Beatty TKM. The effect of energy price shocks on household food security in low-income households. Economic Research Service website. https://www.ers.usda.gov/publications/pub-details/?pubid=84240. Published July 2017. Accessed September 11, 2017.

        • Biros M.H.
        • Hoffman P.L.
        • Resch K.
        The prevalence and perceived health consequences of hunger in emergency department patient populations.
        Acad Emerg Med. 2005; 12: 310-317
        • Sullivan A.F.
        • Clark S.
        • Pallin D.J.
        • Camargo
        • Carlos Jr., A.
        Food security, health, and medication expenditures of emergency department patients.
        J Emerg Med. 2010; 38: 524-528
        • Cook J.T.
        • Frank D.A.
        • Levenson S.M.
        • et al.
        Child food insecurity increases risks posed by household food insecurity to young children's health.
        J Nutr. 2006; 136: 1073-1076
        • Nord M.
        • Kantor L.S.
        Seasonal variation in food insecurity is associated with heating and cooling costs among low-income elderly Americans.
        J Nutr. 2006; 136: 2939-2944
        • Frank D.A.
        • Neault N.B.
        • Skalicky A.
        • et al.
        Heat or eat: The low income home energy assistance program and nutritional and health risks among children less than 3 years of age.
        Pediatrics. 2006; 118: e1293-e1302
        • Gundersen C.
        • Kreider B.
        Bounding the effects of food insecurity on children’s health outcomes.
        J Health Econ. 2009; 28: 971-983
        • Gundersen C.
        • Ziliak J.P.
        Food insecurity and health outcomes.
        Health Affairs. 2015; 34: 1830-1839
        • Holben D.H.
        Position of the American Dietetic Association: Food insecurity in the United States.
        J Am Diet Assoc. 2010; 110: 1368-1377
        • Hanson K.L.
        • Connor L.M.
        Food insecurity and dietary quality in US adults and children: A systematic review.
        Am J Clin Nutr. 2014; 100: 684-692
        • Laraia B.A.
        Food insecurity and chronic disease.
        Adv Nutr. 2013; 4: 203-212
        • Dixon L.B.
        • Winkleby M.A.
        • Radimer K.L.
        Dietary intakes and serum nutrients differ between adults from food-insufficient and food-sufficient families: Third National Health and Nutrition Examination Survey, 1988-1994.
        J Nutr. 2001; 131: 1232-1246
        • Kaiser L.L.
        • Townsend M.S.
        Food insecurity among US children: Implications for nutrition and health.
        Top Clin Nutr. 2005; 20: 313-320
        • Casey P.H.
        • Szeto K.
        • Lensing S.
        • Bogle M.
        • Weber J.
        Children in food-insufficient, low-income families: Prevalence, health, and nutrition status.
        Arch Pediatr Adolesc Med. 2001; 155: 508-514
        • Lorson B.A.
        • Melgar-Quinonez H.
        • Taylor C.A.
        Correlates of fruit and vegetable intakes in US children.
        J Am Diet Assoc. 2009; 109: 474-478
        • Widome R.
        • Neumark-Sztainer D.
        • Hannan P.J.
        • Haines J.
        • Story M.
        Eating when there is not enough to eat: Eating behaviors and perceptions of food among food-insecure youths.
        Am J Public Health. 2009; 99: 822-828
        • Cook J.T.
        • Black M.
        • Chilton M.
        • et al.
        Are food insecurity's health impacts underestimated in the US population? Marginal food security also predicts adverse health outcomes in young US children and mothers.
        Adv Nutr. 2013; 4: 51-61
      17. Oostra R. A case to end U.S. hunger using collaboration to improve population health. ProMedica website. https://www.promedica.org/Public%20Documents/a-case-to-end-hunger.pdf. Accessed September 11, 2017.

        • Chi D.L.
        • Masterson E.E.
        • Carle A.C.
        • Mancl L.A.
        • Coldwell S.E.
        Socioeconomic status, food security, and dental caries in US children: Mediation analyses of data from the National Health and Nutrition Examination Survey, 2007-2008.
        Am J Public Health. 2014; 104: 860-864
        • Eicher-Miller H.
        • Mason A.C.
        • Weaver C.M.
        • McCabe G.P.
        • Boushey C.J.
        Food insecurity is associated with diet and bone mass disparities in early adolescent males but not females in the United States.
        J Nutr. 2011; 141: 1738-1745
        • To Q.G.
        • Frongillo E.A.
        • Gallegos D.
        • Moore J.B.
        Household food insecurity is associated with less physical activity among children and adults in the US population.
        J Nutr. 2014; 144: 1797-1802
        • Kaur J.
        • Lamb M.M.
        • Ogden C.L.
        The association between food insecurity and obesity in children: The national health and nutrition examination survey.
        J Acad Nutr Diet. 2015; 115: 751-758
        • Holben D.H.
        • Taylor C.A.
        Food insecurity and its association with central obesity and other markers of metabolic syndrome among persons aged 12 to 18 years in the United States.
        J Am Osteopath Assoc. 2015; 115: 536-543
        • Lohman B.J.
        • Stewart S.
        • Gundersen C.
        • Garasky S.
        • Eisenmann J.C.
        Adolescent overweight and obesity: Links to food insecurity and individual, maternal, and family stressors.
        J Adolesc Health. 2009; 45: 230-237
        • Nguyen B.T.
        • Ford C.N.
        • Yaroch A.L.
        • Shuval K.
        • Drope J.
        Food security and weight status in children: Interactions with food assistance programs.
        Am J Prev Med. 2017; 52: S138-S144
        • Larson N.I.
        • Story M.T.
        Food insecurity and weight status among US children and families: A review of the literature.
        Am J Prev Med. 2011; 40: 166-173
        • Berkowitz S.A.
        • Seligman H.K.
        • Choudhry N.K.
        Treat or eat: Food insecurity, cost-related medication underuse, and unmet needs.
        Am J Med. 2014; 127: 303-310.e3
        • Bhattacharya J.
        • Currie J.
        • Haider S.
        Poverty, food insecurity, and nutritional outcomes in children and adults.
        J Health Econ. 2004; 23: 839-862
      18. Gregory C, Ver Ploeg M, Andrews M, Coleman-Jensen A. Supplemental Nutrition Assistance Program (SNAP) participation leads to modest changes in diet quality. Economic Research Service website. https://www.ers.usda.gov/publications/pub-details/?pubid=45062. Updated April 24, 2013. Accessed September 11, 2017.

        • Nguyen B.T.
        • Shuval K.
        • Njike V.Y.
        • Katz D.L.
        The Supplemental Nutrition Assistance Program and dietary quality among US adults: Findings from a nationally representative survey.
        Mayo Clin Proc. 2014; 89: 1211-1219
        • Zizza C.A.
        • Duffy P.A.
        • Gerrior S.A.
        Food insecurity is not associated with lower energy intakes.
        Obesity (Silver Spring). 2008; 16: 1908-1913
        • Gowda C.
        • Hadley C.
        • Aiello A.E.
        The association between food insecurity and inflammation in the US adult population.
        Am J Public Health. 2012; 102: 1579-1586
        • Grandner M.A.
        • Petrov M.E.R.
        • Rattanaumpawan P.
        • Jackson N.
        • Platt A.
        • Patel N.P.
        Sleep symptoms, race/ethnicity, and socioeconomic position.
        J Clin Sleep Med. 2013; 9: 897
        • Crews D.C.
        • Kuczmarski M.F.
        • Grubbs V.
        • et al.
        Effect of food insecurity on chronic kidney disease in lower-income Americans.
        Am J Nephrol. 2014; 39: 27-35
        • Leung C.W.
        • Epel E.S.
        • Willett W.C.
        • Rimm E.B.
        • Laraia B.A.
        Household food insecurity is positively associated with depression among low-income Supplemental Nutrition Assistance Program participants and income-eligible nonparticipants.
        J Nutr. 2015; 145: 622-627
      19. Gregory CA, Coleman-Jensen A. Food Insecurity, Chronic Disease, and Health Among Working-Age Adults, ERR-235. https://www.ers.usda.gov/publications/pub-details/?pubid=84466. Updated July 31, 2017. Accessed September 11, 2017.

        • Olson C.M.
        Food insecurity in women: A recipe for unhealthy trade-offs.
        Top Clin Nutr. 2005; 20: 321-328
        • Darmon N.
        • Drewnowski A.
        Contribution of food prices and diet cost to socioeconomic disparities in diet quality and health: A systematic review and analysis.
        Nutr Rev. 2015; 73: 643-660
        • Drewnowski A.
        Obesity, diets, and social inequalities.
        Nutr Rev. 2009; 67: S36-S39
        • Drewnowski A.
        • Specter S.E.
        Poverty and obesity: The role of energy density and energy costs.
        Am J Clin Nutr. 2004; 79: 6-16
        • Seligman H.K.
        • Laraia B.A.
        • Kushel M.B.
        Food insecurity is associated with chronic disease among low-income NHANES participants.
        J Nutr. 2010; 140: 304-310
        • Gucciardi E.
        • Vahabi M.
        • Norris N.
        • Del Monte J.P.
        • Farnum C.
        The intersection between food insecurity and diabetes: A review.
        Curr Nutr Rep. 2014; 3: 324-332
        • Berkowitz S.A.
        • Baggett T.P.
        • Wexler D.J.
        • Huskey K.W.
        • Wee C.C.
        Food insecurity and metabolic control among U.S. adults with diabetes.
        Diabetes Care. 2013; 36: 3093-3099
        • Iglesias-Rios L.
        • Bromberg J.E.
        • Moser R.P.
        • Augustson E.M.
        Food insecurity, cigarette smoking, and acculturation among Latinos: Data from NHANES 1999-2008.
        J Immigr Minor Health. 2015; 17: 349-357
        • Cutler-Triggs C.
        • Fryer G.E.
        • Miyoshi T.J.
        • Weitzman M.
        Increased rates and severity of child and adult food insecurity in households with adult smokers.
        Arch Pediatr Adolesc Med. 2008; 162: 1056-1062
        • McIntyre L.
        • Glanville N.T.
        • Raine K.D.
        • Dayle J.B.
        • Anderson B.
        • Battaglia N.
        Do low-income lone mothers compromise their nutrition to feed their children?.
        CMAJ. 2003; 168: 686-691
        • Park C.Y.
        • Eicher-Miller H.
        Iron deficiency is associated with food insecurity in pregnant females in the United States: National Health and Nutrition Examination Survey 1999-2010.
        J Acad Nutr Diet. 2014; 114: 1967-1973
      20. Ziliak JP, Gundersen C, Haist MP. The causes, consequences, and future of senior hunger in America. National Foundation to End Senior Hunger website. https://www.nfesh.org/wp-content/uploads/2013/03/Causes+Consequences+and+Future+of+Senior+Hunger+2008.pdf. Published 2008. Accessed August 8, 2017.

      21. DelVecchio Dys T, Hake M, Morgan B, O’Leary M. Baby boomers and beyond: Facing hunger after fifty. Feeding America website. http://www.feedingamerica.org/hunger-in-america/our-research/senior-hunger-research/baby-boomers-executive-summary.pdf. Published July 2015. Accessed August 8, 2017.

        • Sattler E.L.P.
        • Lee J.S.
        • Bhargava V.
        Food insecurity and medication adherence in low-income older Medicare beneficiaries with type 2 diabetes.
        J Nutr Gerontol Geriatr. 2014; 33: 401-417
        • Hernandez D.C.
        • Reesor L.
        • Murillo R.
        Gender disparities in the food insecurity-overweight and food insecurity-obesity paradox among low-income older adults.
        J Acad Nutr Diet. 2017; 117: 1087-1096
        • Lee J.S.
        • Frongillo E.A.
        • J
        Nutritional and health consequences are associated with food insecurity among U.S. elderly persons.
        J Nutr. 2001; 131: 1503-1509
      22. Ortman JM, Velkoff VA, Hogan H. An aging nation: The older population in the United States: Population estimates and projections. US Census Bureau website. https://www.census.gov/prod/2014pubs/p25-1140.pdf. Issued May 2014. Accessed August 8, 2017.

        • Tarasuk V.
        • Mitchell A.
        • McLaren L.
        • McIntyre L.
        Chronic physical and mental health conditions among adults may increase vulnerability to household food insecurity.
        J Nutr. 2013; 143: 1785-1793
        • Seligman H.K.
        • Bolger A.F.
        • Guzman D.
        • López A.
        • Bibbins-Domingo K.
        Exhaustion of food budgets at month's end and hospital admissions for hypoglycemia.
        Health Aff (Millwood). 2014; 33: 116-123
        • Tarasuk V.
        • Cheng J.
        • de Oliveira C.
        • Dachner N.
        • Gundersen C.
        • Kurdyak P.
        Association between household food insecurity and annual health care costs.
        CMAJ. 2015; 187: E429-E436
        • Berwick D.M.
        • Nolan T.W.
        • Whittington J.
        The triple aim: Care, health, and cost.
        Health Aff (Millwood). 2008; 27: 759-769
        • McCullum C.
        • Desjardins E.
        • Kraak V.I.
        • Ladipo P.
        • Costello H.
        Evidence-based strategies to build community food security.
        J Am Diet Assoc. 2005; 105: 278-283
        • Hager E.R.
        • Quigg A.M.
        • Black M.M.
        • et al.
        Development and validity of a 2-item screen to identify families at risk for food insecurity.
        Pediatrics. 2010; 126: e26-e32
        • Martin D.S.
        Food waste: A solvable problem.
        J Acad Nutr Diet. 2017; 117: 1155
        • Spiker M.L.
        • Hiza H.A.B.
        • Siddiqi S.M.
        • Neff R.A.
        Wasted food, wasted nutrients: Nutrient loss from wasted food in the United States and comparison gaps in dietary intake.
        J Acad Nutr Diet. 2017; 117: 1031-1040
      23. Mabli J, Ohls J, Dragoset L, Castner L, Santos B. Measuring the Effect of Supplemental Nutrition Assistance Program (SNAP) Participation on Food Security. Food and Nutrition Service website. https://fns-prod.azureedge.net/sites/default/files/Measuring2013.pdf. Published August 2013. Accessed October 31, 2017.

        • Handu D.
        • Medrow L.
        • Brown K.
        Preparing future registered dietitian nutritionists for working with food insecurity: A new food insecurity/food banking supervised practice concentration piloted with dietetic interns.
        J Acad Nutr Diet. 2016; 116: 1193-1198