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      Food insecurity among Dutch food bank recipients: a cross-sectional study

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          Abstract

          Objective

          To determine the prevalence of (very) low food security among Dutch food bank recipients, and to identify potential demographic, lifestyle and nutrition-related factors associated with (very) low food security.

          Setting

          11 of 135 Dutch food banks were selected throughout the Netherlands.

          Participants

          251 Dutch food bank recipients participated in the study (93 men and 158 women). Inclusion criteria for participation were: (1) at least 18 years of age, (2) sufficiently fluent in Dutch to participate in oral and written interviews, (3) recipient of a Dutch food bank for at least 1 month and (4) collect own food parcel at the food bank. A single member per household was included.

          Primary outcome

          Level of food security.

          Results

          The prevalence of food insecurity was 72.9% (N=183), of which 40.4% (N=74) reported very low food security. Of the very low food secure participants, 56.8% (N=42) reported they were ever hungry but did not eat because they could not afford enough food in the previous 3 months. Adjusted multinomial logistic regression analyses showed that households without children were less likely to experience low food security (OR 0.39 (95% CI 0.18 to 0.88)) and men (OR 0.24 (95% CI 0.11 to 0.51)) were less likely to experience very low food security, while low-educated recipients (OR 5.05 (95% CI 1.37 to 18.61)) were more likely to experience very low food security. Furthermore, recipients with high satisfaction with overall food intake (OR 0.46 (95% CI 0.27 to 0.78)), high perceived healthiness of overall food intake (OR 0.34 (95% CI 0.19 to 0.62)) or high self-efficacy of eating healthy (OR 0.62 (95% CI 0.40 to 0.96)) were less likely to experience very low food security.

          Conclusions

          Our study showed high prevalence rates of food insecurity among Dutch food bank recipients, and identified subgroups at increased risk of food insecurity. More research is urgently needed on the underlying determinants of food insecurity and the effectiveness of food assistance by food banks.

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          Most cited references24

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          Food insecurity is associated with iron deficiency anemia in US adolescents.

          Food insecurity, a condition of low or very low food security, is associated with decreased nutrient intake and poor health, which can lead to nutrient deficiency in children, including iron deficiency and iron deficiency anemia. The purpose of this study was to formally investigate the current relation of iron status and food security status among children aged 3-19 y (n = 11,247). Participants of the National Health and Nutrition Examination Survey 1999-2004 were classified for food security status by using the US Children's Food Security Scale and the US Household Food Security Scale. Iron deficiency was defined as > or =2 abnormal values for transferrin saturation, serum ferritin, and erythrocyte protoporphyrin, with the addition of abnormal hemoglobin to classify iron deficiency anemia. The odds of iron deficiency anemia among children aged 12-15 y were 2.95 times (95% CI: 1.18, 7.37; P = 0.02) those for children in households with food insecurity among children compared with children in households with food security among children. The results of this study indicate a continuing need for successful interventions to reduce iron deficiency anemia among food-insecure children and to improve food security among children.
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            Nutrient intakes of individuals from food-insufficient households in the United States.

            Understanding the nutritional consequences of food insufficiency is important for informed policy-making that addresses the problem of domestic hunger. This study estimated the extent to which individuals from food-insufficient households were likely to have low intakes of energy and 14 other nutrients. The diets of pre-schoolers, adult women, and the elderly were analyzed with 24-hour recall data from the 1989 through 1991 Continuing Survey of Food Intake by Individuals. Logistic regression analysis was used to study the association of self-reported household food insufficiency with nutrient intakes below 50% of the recommended daily allowance. For adult women, food insufficiency was significantly associated with low intakes of eight nutrients, including energy, magnesium, and vitamins A, E, C, and B6. Elderly individuals in the food-insufficient group were also more likely to have low intakes of eight nutrients, including protein, calcium, and vitamins A and B6. Household food insufficiency was not significantly associated with low intakes among preschoolers. The results validate the use of self-reported hunger measures in nutritional surveillance and highlight nutrients of concern for food assistance and nutrition education efforts targeted at individuals from food-insufficient households.
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              Feeding her children, but risking her health: the intersection of gender, household food insecurity and obesity.

              This paper investigates one explanation for the consistent observation of a strong, negative correlation in the United States between income and obesity among women, but not men. We argue that a key factor is the gendered expectation that mothers are responsible for feeding their children. When income is limited and households face food shortages, we predict that an enactment of these gendered norms places mothers at greater risk for obesity relative to child-free women and all men. We adopt an indirect approach to study these complex dynamics using data on men and women of childrearing age and who are household heads or partners in the 1999-2003 waves of the Panel Study of Income Dynamics (PSID). We find support for our prediction: Food insecure mothers are more likely than child-free men and women and food insecure fathers to be overweight or obese and to gain more weight over four years. The risks are greater for single mothers relative to mothers in married or cohabiting relationships. Supplemental models demonstrate that this pattern cannot be attributed to post-pregnancy biological changes that predispose mothers to weight gain or an evolutionary bias toward biological children. Further, results are unchanged with the inclusion of physical activity, smoking, drinking, receipt of food stamps, or Women, Infants and Children (WIC) nutritional program participation. Obesity, thus, offers a physical expression of the vulnerabilities that arise from the intersection of gendered childcare expectations and poverty. Copyright © 2012 Elsevier Ltd. All rights reserved.
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                Author and article information

                Journal
                BMJ Open
                BMJ Open
                bmjopen
                bmjopen
                BMJ Open
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2044-6055
                2014
                16 May 2014
                : 4
                : 5
                : e004657
                Affiliations
                [1 ]Department of Health Sciences and the EMGO Institute for Health and Care Research, Faculty of Earth and Life Sciences, VU University Amsterdam , Amsterdam, The Netherlands
                [2 ]Department of Epidemiology and Biostatistics, VU University Medical Center , Amsterdam, The Netherlands
                Author notes
                [Correspondence to ] Judith E Neter; judith.neter@ 123456vu.nl
                Article
                bmjopen-2013-004657
                10.1136/bmjopen-2013-004657
                4025443
                24838723
                007e9ebf-673d-427f-adb9-cef895ed6ff9
                Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions

                This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/

                History
                : 10 December 2013
                : 16 April 2014
                : 23 April 2014
                Categories
                Public Health
                Research
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                Medicine
                Medicine

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