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      Food Insecurity, Poor Diet Quality, and Suboptimal Intakes of Folate and Iron Are Independently Associated with Perceived Mental Health in Canadian Adults

      research-article
      1 , * , 2 , 3
      Nutrients
      MDPI
      food insecurity, diet quality, nutrient intakes, mental health

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          Abstract

          Background: To address nutrition-related population mental health data gaps, we examined relationships among food insecurity, diet quality, and perceived mental health. Methods: Stratified and logistic regression analyses of respondents aged 19–70 years from the Canadian Community Health Survey, Cycle 2.2 were conducted ( n = 15,546). Measures included the Household Food Security Survey Module, diet quality (i.e., comparisons to the Dietary Reference Intakes, Healthy Eating Index), perceived mental health (poor versus good), sociodemographics, and smoking. Results: In this sample, 6.9% were food insecure and 4.5% reported poor mental health. Stratified analysis of food security and mental health status by age/gender found associations for poor diet quality, protein, fat, fibre, and several micronutrients ( p-values < 0.05); those who were food insecure tended to have higher suboptimal intakes ( p-values < 0.05). After adjustment for covariates, associations in relation to mental health emerged for food insecurity (OR = 1.60, 95% CI 1.45–1.71), poor diet quality (1.61, 95% CI 1.34–1.81), and suboptimal intakes of folate (OR = 1.58, 95% CI 1.17–1.90) and iron (OR = 1.45, 95% CI 1.23–1.88). Conclusions: Population approaches that improve food security and intakes of high quality diets may protect people from poor mental health.

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          Most cited references58

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          Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids

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            Conceptual framework for understanding the bidirectional links between food insecurity and HIV/AIDS.

            Food insecurity, which affects >1 billion people worldwide, is inextricably linked to the HIV epidemic. We present a conceptual framework of the multiple pathways through which food insecurity and HIV/AIDS may be linked at the community, household, and individual levels. Whereas the mechanisms through which HIV/AIDS can cause food insecurity have been fairly well elucidated, the ways in which food insecurity can lead to HIV are less well understood. We argue that there are nutritional, mental health, and behavioral pathways through which food insecurity leads to HIV acquisition and disease progression. Specifically, food insecurity can lead to macronutrient and micronutrient deficiencies, which can affect both vertical and horizontal transmission of HIV, and can also contribute to immunologic decline and increased morbidity and mortality among those already infected. Food insecurity can have mental health consequences, such as depression and increased drug abuse, which, in turn, contribute to HIV transmission risk and incomplete HIV viral load suppression, increased probability of AIDS-defining illness, and AIDS-related mortality among HIV-infected individuals. As a result of the inability to procure food in socially or personally acceptable ways, food insecurity also contributes to risky sexual practices and enhanced HIV transmission, as well as to antiretroviral therapy nonadherence, treatment interruptions, and missed clinic visits, which are strong determinants of worse HIV health outcomes. More research on the relative importance of each of these pathways is warranted because effective interventions to reduce food insecurity and HIV depend on a rigorous understanding of these multifaceted relationships.
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              Homocysteine and vascular disease.

              For more than 20 years, moderately raised concentrations of total homocysteine (tHcy) have been associated with an increased risk of atherothrombotic vascular events but only recently has evidence mounted to suggest that the association may be causal. The association is independent of other factors, it is fairly consistent across many studies, it is strong and dose-related, and it is biologically plausible. However, the evidence needs to be strengthened by a systematic review of all comparable studies and the demonstration, in randomised trials, that lowering tHcy is followed by a significant reduction in atherothrombotic vascular disease. In addition, the measurement of tHcy needs to be standardised. If these can be achieved then tHcy measurement will become another useful marker of vascular risk, multivitamin therapy will be another therapeutic option for people at risk of atherothrombotic vascular disease, and fortification of food with folic acid will rise high on the political and public health agenda.
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                Author and article information

                Journal
                Nutrients
                Nutrients
                nutrients
                Nutrients
                MDPI
                2072-6643
                14 March 2017
                March 2017
                : 9
                : 3
                Affiliations
                [1 ]School of Nursing, University of British Columbia and Health Science Program, Department of Biology, Kwantlen Polytechnic University, Surrey, BC V3W 2M8, Canada
                [2 ]Department of Computer Science, University of Illinois Springfield and Department of Computer Science, Simon Fraser University, Burnaby, BC V5A 1S6, Canada; lvdp00@ 123456gmail.com
                [3 ]Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada; kaplan@ 123456ucalgary.ca
                Author notes
                [* ]Correspondence: Karen.davison@ 123456kpu.ca ; Tel.: +1-604-300-0331
                Article
                nutrients-09-00274
                10.3390/nu9030274
                5372937
                28335418
                74cb6532-7e77-40c4-a4ed-c492c6bc6ca5
                © 2017 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                Categories
                Article

                Nutrition & Dietetics
                food insecurity,diet quality,nutrient intakes,mental health
                Nutrition & Dietetics
                food insecurity, diet quality, nutrient intakes, mental health

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