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Food Insecurity, Nutrition and Obesity Outcomes in Adolescents and Young Adults

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A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutrition and Public Health".

Deadline for manuscript submissions: closed (15 February 2023) | Viewed by 27408

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Special Issue Editors

Prof. Dr. Melanie K. Bean

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Guest Editor

Department of Pediatrics, Children’s Hospital of Richmond at Virginia Commonwealth University and Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
Interests: adolescent obesity treatment and nutrition and obesity policy; understanding and reducing systematic inequities that drive persistent racial, ethnic, and socioeconomic disparities in obesity and related conditions

Prof. Dr. Jessica G. LaRose

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Guest Editor

Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA, USA
Interests: understanding the interplay of behavioral, psychological, and environmental determinants of obesity and cardiometabolic risk; developing novel and sustainable interventions to promote cardiovascular health and psychological wellbeing among underserved populations

Special Issue Information

Dear Colleagues,

Adolescent and young adult (AYA) developmental periods are marked by high rates of overweight and obesity, and suboptimal dietary patterns are frequently observed. Food insecurity is also prominent among AYAs, contributing to racial and ethnic inequities in numerous chronic illnesses, including obesity and obesity- and diet-related comorbidities. Food insecurity likely plays a role in the less optimal responses to dietary and obesity interventions that are observed in individuals from systematically minoritized backgrounds, who often lack consistent access to healthy food. The AYA developmental period is unique from other age groups, with increasing evidence that dietary and obesity intervention approaches must be appropriately tailored to these age groups, yet AYAs are under-represented in the scientific literature in this area, with particular gaps among AYAs with food insecurity. There is thus a great need to advance understanding of the interplay between food insecurity and nutrition and obesity outcomes during these developmental periods, to build an evidence base to inform policy, public health, clinical, and scientific agendas, and ultimately reduce nutritional and obesity inequities.

This Special Issue of Nutrients entitled “Food Insecurity and Nutrition and Obesity Outcomes in Adolescents and Young Adults” welcomes the submission of original manuscripts describing research conducted in adolescents and/or young adults, spanning ages ~12–29 years, working on this topic. Longitudinal investigations, intervention research (including randomized controlled or clinical trials), cross-sectional studies, systematic reviews, meta-analyses, and commentaries are welcome, as are studies that span community, school, clinical, and other settings.

Prof. Dr. Melanie K. Bean
Prof. Dr. Jessica G. LaRose
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Nutrients is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

food insecurity
nutrition insecurity
adolescents
young adults
obesity
dietary behaviors
dietary intake

Published Papers (11 papers)

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10 pages, 51262 KiB

Open AccessArticle

A Spatial Analysis of Food Insecurity and Body Mass Index with Income and Grocery Store Density in a Diverse Sample of Adolescents and Young Adults

by Joanna Buscemi, Alexander O’Donnell, Mary Takgbajouah and Paige Patano

Nutrients 2023, 15(6), 1435; https://doi.org/10.3390/nu15061435 - 16 Mar 2023

Cited by 1 | Viewed by 1898

Abstract

Food insecurity occurs when a household lacks consistent access to food and is more prevalent in ethnic and racial minority populations. While there has been a proliferation of research linking food insecurity to obesity, these findings are mixed. It may be helpful to consider some additional geographic factors that may be associated with both factors including socioeconomic status and grocery store density. The purpose of the current study aimed to examine spatial relationships between food insecurity and SES/store density and BMI and SES/store density in a diverse sample of adolescents and young adults across two studies in a large, urban city. GIS analysis revealed that participants with the highest food insecurity tend to live in the zip codes with the lowest median income. There did not appear to be clear a relationship between food insecurity and store density. Participants with the highest BMI tend to live in zip codes with lower median income and participants with higher BMI tended to live in the south and west sides of Chicago, which have a relatively lower concentration of grocery stores in the city. Our findings may help to inform future interventions and policy approaches to addressing both obesity and food insecurity in areas of higher prevalence. Full article

(This article belongs to the Special Issue Food Insecurity, Nutrition and Obesity Outcomes in Adolescents and Young Adults)

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12 pages, 283 KiB

Open AccessArticle

Profile of a Food-Insecure College Student at a Major Southeastern University: A Randomized Cross-Sectional Study

by Cedric Harville II, Delores C. S. James and Arné Burns

Nutrients 2023, 15(5), 1108; https://doi.org/10.3390/nu15051108 - 23 Feb 2023

Cited by 1 | Viewed by 1716

Abstract

Ten percent of Americans are food-insecure. Few known studies have accessed college food insecurity via random sampling. An online cross-sectional survey (n = 1087) was distributed via email to a random sample of undergraduate college students. Food insecurity was determined by the USDA Food Security Short Form. Data were analyzed using JMP Pro. Results: Thirty-six percent of the students were food-insecure. Most food-insecure students were enrolled full-time (93.6%), female (81.2%), received financial aid (77.9%), lived off-campus (75.0%), non-white (59.6%), and employed (51.7%). Food-insecure students had a significantly lower GPA (p < 0.001 *), were more likely to be non-white (p < 0.0001 *), and were more likely to have received financial aid compared to food-secure students (p < 0.0001 *). Food-insecure students were significantly more likely to have lived in government housing, had free or reduced lunch, used SNAP and WIC benefits, and received food from a food bank during childhood (p < 0.0001 * for all). Food-insecure students were significantly less likely to report that they experienced a food shortage to counseling and wellness personnel, a resident assistant, and their parents (p < 0.05 * for all). Discussion: College students might be at greater risk for food insecurity if they are non-white, first-generation students, employed, on financial aid, and have a history of accessing government assistance during childhood. Full article

(This article belongs to the Special Issue Food Insecurity, Nutrition and Obesity Outcomes in Adolescents and Young Adults)

11 pages, 424 KiB

Open AccessArticle

Testing a Biobehavioral Model of Food Insecurity and Chronic Disease in Hispanic Older Adolescents

by Diana Rancourt, Faith A. Heeren and Michelle Cardel

Nutrients 2023, 15(4), 1027; https://doi.org/10.3390/nu15041027 - 18 Feb 2023

Cited by 1 | Viewed by 2015

Abstract

The biobehavioral model of food insecurity and chronic disease posits that stress perpetuates the cycle of food insecurity and chronic disease, in part, through changes in eating behaviors and weight gain. The current study conducted a preliminary test of the biobehavioral model in a sample of Hispanic older adolescents. It was hypothesized that older adolescents experiencing food insecurity would report greater depressive symptoms, which would be associated with more disordered eating, which would be associated with worse cardiometabolic indicators. Hispanic older adolescents (N = 113; 60% female; 15–21 years with mean age of 19.1; BMI_mean = 24.4) completed self-report baseline measures of food insecurity, depression, and disordered eating behaviors as part of a larger experimental study. Anthropometrics and body composition, blood pressure, heart rate, and resting metabolic rate were objectively measured. Hypotheses were tested using structural equation modeling. Experiencing food insecurity was associated with more disordered eating (b = 2.20, p = 0.032). Greater depressive symptoms were associated with more disordered eating (b = 0.28, p = 0.025) and worse cardiometabolic indicators (b = 0.15, p = 0.017). The full biobehavioral model, however, was not supported. Findings underscore the complex interaction of social and psychological functioning and physical health. Full article

(This article belongs to the Special Issue Food Insecurity, Nutrition and Obesity Outcomes in Adolescents and Young Adults)

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18 pages, 799 KiB

Open AccessArticle

Diet Quality and Contextual Factors Influencing Food Choice among Adolescents with Food Security and Food Insecurity in Baltimore City

by Kaitlyn Harper, Laura E. Caulfield, Stacy V. Lu, Kristin Mmari and Susan M. Gross

Nutrients 2022, 14(21), 4573; https://doi.org/10.3390/nu14214573 - 31 Oct 2022

Cited by 2 | Viewed by 2477

Abstract

This study evaluated differences in overall diet quality, diet quality components, and food-related contextual factors between adolescents with food security and those with food insecurity. Mixed methods analysis was conducted on data from three 24-h dietary recalls from 61 adolescents ages 14–19 years old living in Baltimore, Maryland, USA in 2020–2021. All adolescents were sampled from households eligible for the Supplemental Nutrition Assistance Program in 2020. There were no significant differences in overall diet quality or components between adolescents with food security and those with food insecurity in this sample, except for seafood and plant proteins, which was higher for adolescents with food insecurity. Qualitative analysis found that adolescents were largely influenced by their parents and the home food environment, and that workplace environments enabled adolescents to eat foods high in refined grains, sugar, and saturated fat. These findings provide insight about the experiences of low-income adolescents during times when they are home for prolonged periods (i.e., emergency school closures, summer, and winter breaks). Programs and policies that aim to improve healthy food access may positively impact adolescent food security and diet quality, and it is important to ensure that healthy foods are available and accessible to adolescents in the places where they spend the most time. Multilevel interventions in the home, school, and workplace may be most effective in encouraging healthy eating behaviors among adolescents. Full article

(This article belongs to the Special Issue Food Insecurity, Nutrition and Obesity Outcomes in Adolescents and Young Adults)

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14 pages, 615 KiB

Open AccessArticle

Diet Quality among Students Attending an Australian University Is Compromised by Food Insecurity and Less Frequent Intake of Home Cooked Meals. A Cross-Sectional Survey Using the Validated Healthy Eating Index for Australian Adults (HEIFA-2013)

by Yumeng Shi, Amanda Grech and Margaret Allman-Farinelli

Nutrients 2022, 14(21), 4522; https://doi.org/10.3390/nu14214522 - 27 Oct 2022

Cited by 4 | Viewed by 2783

Abstract

Poor diet quality is commonly reported in young adults. This study aimed to measure the diet quality of students attending a large Australian university (including domestic and international students), and to examine the effect of food security status and other key factors likely to impact their diet quality. Using the Automated Self-Administered 24-h recall Australian version, a cross-sectional survey collected dietary recalls from domestic and international students in one university in Sydney. Diet quality was assessed using the validated Healthy Eating Index for Australian Adults (HEIFA-2013) which gives a score out of 100. Food security status was measured by the 18-item Household Food Security Survey Module. Differences in the mean HEIFA-2013 scores by student characteristics were determined by analysis of covariance. A total of 141 students completed one dietary recall. The mean HEIFA-2013 score for students was low (mean 52.4, 95% CI 50.0–54.8). Food-insecure students had a poorer diet quality (mean 43.7, 95% CI 35.7–51.8) than their food-secure peers (mean 53.2, 95% CI 50.8–55.7, p = 0.027). The mean HEIFA-2013 score was similar in domestic (mean 52.5, 95% CI 49.9–55.2) and international students (mean 51.9, 95% CI 46.3–57.5, p = 0.845). Those reporting self-perceived excellent cooking skills and higher cooking frequency had better diet quality. Interventions to improve food and nutrition knowledge and skills and address food insecurity may help tertiary education students cook more frequently and achieve better diet quality. Full article

(This article belongs to the Special Issue Food Insecurity, Nutrition and Obesity Outcomes in Adolescents and Young Adults)

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13 pages, 855 KiB

Open AccessArticle

Differences in Measured and Self-Categorized Food Security Status and Related Coping Strategies among College Students

by Megan D. Engel, Karla P. Shelnutt, Lisa A. House, Aseel El Zein and Anne E. Mathews

Nutrients 2022, 14(17), 3569; https://doi.org/10.3390/nu14173569 - 30 Aug 2022

Cited by 2 | Viewed by 1679

Abstract

Qualitative studies suggest that college students with food insecurity (FI) experience stigma and misinterpret some of the USDA Adult Food Security Survey Module (AFSSM) questions, leading to misclassification of food security (FS) status. We aimed to evaluate differences in AFSSM-measured FS status and self-categorized FS status (based on USDA descriptions of the four FS levels) among college students, and to identify differences in the coping strategies and BMI of these students. Data were collected cross-sectionally from a convenience sample via web-based, self-reported surveys. Measured FS, self-categorized FS, coping strategies, and self-reported BMI were key variables of interest. Participants were 1003 undergraduate and graduate students (22.2 ± 4.6 years; 65.7% female). Of the participants measured as food insecure (40.0%), 57.8% self-categorized as food secure (MFI-SFS) and 42.2% self-categorized as food insecure (MFI-SFI). Significantly more MFI-SFI participants were AFSSM-categorized as having very low FS when compared to MFI-SFS participants (71.6% vs. 46.6%, p < 0.05). MFI-SFI participants reported significantly higher BMI (M = 24.7, SD ± 6.0 kg/m²) and coping strategies scores (M = 49.8, SD ± 7.5) when compared to MFI-SFS participants (M = 23.1, SD ± 3.6 kg/m²; M = 46.9, SD ± 7.5, respectively, p ≤ 0.01). Assessment of and interventions to address FI among college students should consider the potential influence of self-perception and students’ interpretation of survey questions. Full article

(This article belongs to the Special Issue Food Insecurity, Nutrition and Obesity Outcomes in Adolescents and Young Adults)

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15 pages, 340 KiB

Open AccessArticle

Social Determinants of Obesity and Stunting among Brazilian Adolescents: A Multilevel Analysis

by Diôgo Vale, Maria Eduarda da Costa Andrade, Natalie Marinho Dantas, Ricardo Andrade Bezerra, Clélia de Oliveira Lyra and Angelo Giuseppe Roncalli da Costa Oliveira

Nutrients 2022, 14(11), 2334; https://doi.org/10.3390/nu14112334 - 2 Jun 2022

Cited by 4 | Viewed by 2578

Abstract

(1) Background: The purpose of this study was to identify the prevalence of obesity and stunting among Brazilian adolescents and its associations with social determinants of health (individual, family, and school), grounded on the necessity of investigating the determinants of nutritional problems within this population. (2) Methods: A population-based survey was administered to 16,556 adolescents assessed by the 2015 National School Health Survey. Multivariate models of obesity and stunting were estimated from Multilevel Poisson Regressions. (3) Results: The prevalence of obesity among Brazilian adolescents (10.0%; 95% CI: 9.4–10.6) was associated directly with indifference or dissatisfaction with body image, with eating breakfast four or fewer days a week, living with up to four people in the household, studying in private schools, and being from the South region, and was inversely associated with being female, 15 years old or older, with having the highest nutritional risk eating pattern, dining at fast-food restaurants, and eating while watching television or studying. The prevalence of stunting (2.3%; 95% CI: 2.0–2.8) was directly associated with the age of 15 years or older, and inversely associated with the lower number of residents living in the household, maternal education—decreasing gradient from literate to college level education, studying in urban schools, and being from the South and Central-West regions. (4) Conclusions: Obesity in adolescence presented behavioral determinants. Stunting and obesity have structural social determinants related, respectively, to worse and better socioeconomic position among Brazilian adolescents. Full article

(This article belongs to the Special Issue Food Insecurity, Nutrition and Obesity Outcomes in Adolescents and Young Adults)

21 pages, 931 KiB

Open AccessArticle

Feasibility of a Home-Delivery Produce Prescription Program to Address Food Insecurity and Diet Quality in Adults and Children

by Laura Fischer, Nia Bodrick, Eleanor R. Mackey, Anthony McClenny, Wayde Dazelle, Kristy McCarron, Tessa Mork, Nicole Farmer, Matthew Haemer and Kofi Essel

Nutrients 2022, 14(10), 2006; https://doi.org/10.3390/nu14102006 - 10 May 2022

Cited by 18 | Viewed by 3261

Abstract

Produce prescription programs aim to improve food insecurity (FI) and nutrition but their effectiveness is unclear. We conducted a pilot study to demonstrate the feasibility and explore the potential impact of a family-based, home-delivery produce prescription and nutrition education program. We measured enrollment, satisfaction, participation, and retention as measure of feasibility. Adult participants answered pre-post self-report questionnaires assessing FI, child and adult fruit and vegetable intake, and culinary literacy and self-efficacy. To understand participants’ lived experiences, qualitative interviews were conducted at the 6-month time point. Twenty-five families were enrolled. Feasibility measures indicate participants were generally satisfied with the program but there were important barriers to participation. Qualitative data revealed themes around reduced food hardship, healthy eating, budget flexibility, and family bonding. Fruit and vegetable consumption increased in a small subgroup of children, but post-intervention intake remained below recommended levels, particularly for vegetables. FI scores were not significantly different post-intervention, but qualitative findings indicated improved access and reliability of food. This is the first intervention of its kind to be evaluated for feasibility and our results suggest the intervention is well-received and supportive. However, further study, with a larger sample size, is needed to understand factors influencing participation and assess effectiveness. Full article

(This article belongs to the Special Issue Food Insecurity, Nutrition and Obesity Outcomes in Adolescents and Young Adults)

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14 pages, 2513 KiB

Open AccessArticle

Food Insecurity and the Association between Perceptions and Trust of Food Advertisements and Consumption of Ultra-Processed Foods among U.S. Parents and Adolescents

by Reah Chiong and Roger Figueroa

Nutrients 2022, 14(9), 1964; https://doi.org/10.3390/nu14091964 - 7 May 2022

Cited by 2 | Viewed by 3132

Abstract

Adolescents exposed to food and beverage advertisements (FBAs) typically low in nutrient density can be influenced in their food choices, eating behaviors, and health. This study examines the association between perceptions and trust of FBAs (key predictor) and the outcome of daily consumption of ultra-processed foods (UPFs) in parent-adolescent dyads, with risk of food insecurity as a potential moderator. Cross-sectional data from the Family, Life, Activity, Sun, Health and Eating (FLASHE) study was used to test actor and partner effects using structural equation modeling. The final model was adjusted for parent sex and education level, and effects were compared between dyads at risk of food insecurity (n = 605) and dyads not at risk (n = 1008). In the unadjusted model, actor effects (parent: b = 0.23, p = 0.001; adolescent b = 0.12, p = 0.001) and parent-partner effects were found (b = 0.08, p = 0.004). The final comparative model produced similar results for dyads not at risk of food insecurity (parent actor: b = 0.27, p = 0.001; parent partner: b = 0.10, p = 0.01; adolescent actor: b = 0.11, p = 0.003). For dyads at risk of food insecurity, only actor effects were significant (parent: b = 0.22, p = 0.001; adolescent: b = 0.11, p = 0.013). These findings suggest that parents’ favorability towards FBAs influence parent-adolescent unhealthy food consumption, and that this association is different when accounting for risk of food insecurity. Full article

(This article belongs to the Special Issue Food Insecurity, Nutrition and Obesity Outcomes in Adolescents and Young Adults)

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14 pages, 778 KiB

Open AccessArticle

Home Food Environment Changes and Dietary Intake during an Adolescent Behavioral Weight Loss Intervention Differ by Food Security Status

by Elizabeth L. Adams, Laura J. Caccavale, Jessica Gokee LaRose, Hollie A. Raynor and Melanie K. Bean

Nutrients 2022, 14(5), 976; https://doi.org/10.3390/nu14050976 - 25 Feb 2022

Cited by 3 | Viewed by 2365

Abstract

Behavioral weight loss (BWL) for pediatric obesity includes guidance on improving the home food environment and dietary quality; yet food insecurity presents barriers to making these changes. This study examined if home food environment, dietary quality, energy intake, and body weight changes during adolescent obesity treatment differed by food security status, and if changes in the home food environment were associated with changes in dietary quality and energy intake by food security status. Adolescents (n = 82; 13.7 ± 1.2 years) with obesity participated in a 4-month BWL treatment. Food insecurity, home food environment (Home Food Inventory [HFI]), dietary quality (Healthy Eating Index [HEI]), energy intake, and body mass index (BMI) were assessed at baseline and post-treatment. A reduced obesogenic home food environment and improved dietary quality were observed for food secure (ps < 0.01), but not insecure households (ps > 0.05) (mean difference, HFI: −6.6 ± 6.4 vs. −2.4 ± 7.4; HEI: 5.1 ± 14.4 vs. 2.7 ± 17.7). Energy intake and BMI decreased for adolescents in food secure and insecure households (ps < 0.03) (mean difference; energy intake: −287 ± 417 vs. −309 ± 434 kcal/day; BMI: −1.0 ± 1.4 vs. −0.7 ± 1.4). BWL yielded similar reductions in energy intake and body weight yet did not offer the same benefits for improved dietary quality and the home food environment for adolescents with food insecurity. Full article

(This article belongs to the Special Issue Food Insecurity, Nutrition and Obesity Outcomes in Adolescents and Young Adults)

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Other

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9 pages, 677 KiB

Open AccessOpinion

Food Insecurity and Nutritional Challenges in Adolescent and Young Adult Cancer Survivors in the U.S.A.: A Narrative Review and Call to Action

by Callie Ogland-Hand, Timothy H. Ciesielski, Katherine Daunov, Melanie K. Bean and Nora L. Nock

Nutrients 2023, 15(7), 1731; https://doi.org/10.3390/nu15071731 - 1 Apr 2023

Cited by 4 | Viewed by 1986

Abstract

Advancements in cancer treatments over the past several decades have led to improved cancer survival in adolescents and young adults (AYAs, ages 15–39 years). However, AYA cancer survivors are at an increased risk for “late effects”, including cardiovascular, pulmonary and bone diseases as well as fatigue, infertility and secondary cancers. The treatments for cancer may also alter taste, lead to nutritional deficiencies and increase financial burdens that, when taken together, may increase the risk of food and nutrition security in AYA cancer survivors. Furthermore, although AYAs are often merged together in cancer survivorship studies, adolescents and young adults have distinct developmental, psychosocial and pathophysiological differences that may modify their risk of nutritional challenges. In this narrative review and “Call to Action”, rationale is provided for why there is a need to better understand nutritional challenges and food insecurity in AYA cancer survivors as a special population. Then, recommendations for next steps to advance knowledge and policy in this field are provided. In particular, integrating screening for food and nutrition insecurity and enhancing awareness of existing resources (e.g., the Supplemental Nutrition Assistance Program, SNAP) might help AYA cancer survivors combat nutritional deficiencies and reduce late effects while improving their overall survival and quality of life. Full article

(This article belongs to the Special Issue Food Insecurity, Nutrition and Obesity Outcomes in Adolescents and Young Adults)

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