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      Household food insecurity, diet quality, and weight status among indigenous women (Mah Meri) in Peninsular Malaysia

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          Abstract

          BACKGROUND/OBJECTIVES

          This cross-sectional study assessed household food security status and determined its association with diet quality and weight status among indigenous women from the Mah Meri tribe in Peninsular Malaysia.

          SUBJECTS/METHODS

          The Radimer/Cornell Hunger and Food Insecurity Instrument and the Malaysian Healthy Eating Index (HEI) were used to assess household food security status and diet quality, respectively. Information on socio-demographic characteristics and 24-hour dietary recall data were collected through face-to-face interview, and anthropometric measurements including weight, height, and body mass index (BMI) were obtained from 222 women.

          RESULTS

          Majority of households (82.9%) experienced different levels of food insecurity: 29.3% household food insecurity, 23.4% individual food insecurity, and 30.2% fell into the child hunger group. The food-secure group had significantly fewer children and smaller household sizes than the food-insecure groups ( P < 0.05). The mean household income, income per capita, and food expenditure significantly decreased as food insecurity worsened ( P < 0.001). The food-secure group had significantly higher Malaysian HEI scores for grains and cereals ( P < 0.01), as well as for meat, poultry, and eggs ( P < 0.001), than the food-insecure groups. The child-hunger group had significantly higher fat ( P < 0.05) and sodium ( P < 0.001) scores than the food-secure and household food-insecure groups. Compared to the individual food-insecure and child-hunger groups, multivariate analysis of covariance showed that the food-secure group was significantly associated with a higher Malaysian HEI score while the household food-insecure group was significantly associated with a higher BMI after controlling for age ( P < 0.025).

          CONCLUSIONS

          The majority of indigenous households faced food insecurity. Food insecurity at the individual and child levels was associated with lower quality of diet, while food insecurity at the household level was associated with higher body weight. Therefore, a substantial effort by all stakeholders is warranted to improve food insecurity among poorer households. The results suggest a pressing need for nutritional interventions to improve dietary intake among low income households.

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          Most cited references23

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          Obesity, diets, and social inequalities.

          Obesity and type 2 diabetes follow a socioeconomic gradient. Highest rates are observed among groups with the lowest levels of education and income and in the most deprived areas. Inequitable access to healthy foods is one mechanism by which socioeconomic factors influence the diet and health of a population. As incomes drop, energy-dense foods that are nutrient poor become the best way to provide daily calories at an affordable cost. By contrast, nutrient-rich foods and high-quality diets not only cost more but are consumed by more affluent groups. This article discusses obesity as an economic phenomenon. Obesity is the toxic consequence of economic insecurity and a failing economic environment.
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            Development of indicators to assess hunger.

            Despite widespread concern about hunger in America, efforts to monitor and assess the extent of hunger have been hampered by lack of consensus on an appropriate meaning for the term hunger and by the lack of valid indicators to assess it. The first phase of the research used qualitative methods to derive a socially-appropriate definition of hunger. Thirty-two women in Upstate New York were interviewed regarding their experience with food problems and hunger. The interviews were analyzed using the constant comparative method. Results indicated that women had a narrow and a broad concept of hunger. The narrow concept focused on going without food for a specified period of time and the physical sensation of hunger. The broad one included two dimensions: household and individual hunger. Each had quantitative, qualitative, psychological, and social components. The second phase of the research used survey methodology to examine the validity and reliability of items designed to measure the conceptual definition of hunger. The survey was administered to 189 women in Upstate New York who participated in programs designed for low-income households or households in need of food. The second phase confirmed the conceptualization of hunger developed in the first phase. A subset of valid and reliable items that represented each of the major dimensions and components of hunger was identified as being useful for monitoring and assessing hunger.
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              Food insecurity is highly prevalent and predicts underweight but not overweight in adults and school children from Bogotá, Colombia.

              The aims of this study were to determine the sociodemographic and dietary correlates of household and child food insecurity in Bogotá, Colombia and to examine whether food insecurity is a risk factor for underweight or overweight in this population. We analyzed data from 2359 families with 2526 children 5-12 y of age who completed a cross-sectional survey conducted in 2006. The survey was representative of low- and middle-income families who had children enrolled in the public primary school system of Bogotá. We used a 16-item food insecurity scale, modified from the United States Household Food Security Survey Module, assessed children's dietary intake with a FFQ, and measured their height and weight. Mothers' anthropometry was obtained through self-report. We estimated adjusted prevalence ratios and 95% CI from binomial regression models. Household food insecurity with hunger and child food insecurity were each positively associated with maternal age, parity, and single parent status and inversely related to mean household income and number of home assets. Animal protein and snack food intake were inversely related to child food insecurity. In multivariate analyses, food-insecure children were 3 times more likely to be underweight than food-secure children (95% CI = 1.6, 5.4; P = 0.0007). Hunger in the household was significantly associated with maternal underweight. Food insecurity was not related to child stunting, child overweight, or maternal overweight. The prevalence of food insecurity in Bogotá is high and related to poverty. Food insecurity does not necessarily predict overweight in countries undergoing the nutrition transition.
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                Author and article information

                Journal
                Nutr Res Pract
                Nutr Res Pract
                NRP
                Nutrition Research and Practice
                The Korean Nutrition Society and the Korean Society of Community Nutrition
                1976-1457
                2005-6168
                April 2018
                22 March 2018
                : 12
                : 2
                : 135-142
                Affiliations
                Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, 43400 Selangor, Malaysia.
                Author notes
                Corresponding Author: Norhasmah Sulaiman, Tel. 603-89472461, Fax. 603-89426769, norhasmah@ 123456upm.edu.my
                Author information
                https://orcid.org/0000-0001-7586-1719
                https://orcid.org/0000-0003-4636-6529
                https://orcid.org/0000-0003-1478-6131
                Article
                10.4162/nrp.2018.12.2.135
                5886965
                29629030
                1a1a096e-afa5-45ce-9b59-454d244da693
                ©2018 The Korean Nutrition Society and the Korean Society of Community Nutrition

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 13 October 2017
                : 26 February 2018
                : 02 March 2018
                Categories
                Original Research

                Nutrition & Dietetics
                food security,low income households,healthy eating index,body mass index,child hunger

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