Household Food Sourcing Patterns and Their Associations with Food Insecurity in Appalachian Ohio.

BACKGROUND: Households experiencing food insecurity may use dynamic strategies to meet food needs. Yet, the relationship between household food sourcing behaviors and food security, particularly in rural settings, is understudied. OBJECTIVE: To identify food sourcing patterns and their associations with food insecurity among households in rural Appalachian Ohio during the COVID-19 pandemic. DESIGN: Survey data were collected from a cohort of households in Athens County, Ohio in July 2020, October 2020, January 2021, and April 2021. PARTICIPANTS/SETTING: The sample included 663 households with household food sourcing and food security information for ≥1 survey wave. MAIN OUTCOME MEASURES: Household food sourcing patterns. Households reported the frequency with which they obtained food from various retailers and charitable sources, classified as supercenters, supermarkets, convenience stores, farmers' markets, or charitable sources. STATISTICAL ANALYSES: Principal component analysis was used to identify food sourcing patterns. Linear mixed models were used to assess changes in food sourcing behaviors over the study period and to determine whether food sourcing behaviors differed according to food security status. RESULTS: Two patterns were identified: 1) Convenience Stores and Charitable Food, 2) Supermarkets and Farmers' Markets, not Supercenters. Relative to July 2020, alignment of households' food sourcing behaviors with the "Supermarkets and Farmers' Markets, not Supercenters" pattern was higher in October 2020 (ß=0.07; 95% CI: 0.02, 0.12) and alignment with the "Convenience Stores and Charitable Food" pattern was lower in April 2021 (ß=-0.06; 95% CI: -0.11, -0.02). Compared to food-secure households, food sourcing behaviors of food-insecure households were more closely aligned with the "Convenience Stores and Charitable Food" pattern (ß=0.07; 95% CI: 0.00, 0.13); no statistically significant difference in scores was observed for the "Supermarkets and Farmers' Markets, not Supercenters" pattern (ß=-0.07; 95% CI: -0.15, 0.02). CONCLUSIONS: These findings support efforts to increase access to healthy, affordable options at venues where food-insecure households may be likely to obtain food, such as convenience stores and charitable sources.

Ultraprocessed Food Intake during the Transition to Adulthood Varies According to Sociodemographic Characteristics and Maternal Intake in Cebu, Philippines.

BACKGROUND: Ultraprocessed foods (UPFs) are associated with elevated risk of noncommunicable disease, but little is known about UPF intake and the individual-, household-, and community-level factors associated with it among adolescents in low- or middle-income countries. OBJECTIVES: We estimated the association of UPF intake across adolescence with sociodemographic characteristics and maternal UPF intake in a Filipino cohort. METHODS: Data were from 4 waves (1994-2005) of the Cebu Longitudinal Health and Nutrition Survey (n = 2068); participants were aged 11, 15, 18, and 21 y. Foods from 24-h recalls were classified using NOVA. We used two-part multilevel models to estimate time-varying associations of the odds and amount (percentage daily kilocalories) of UPF intake with sociodemographic characteristics and maternal UPF intake (none, below median among UPF-consuming mothers ["low"], at or above median ["high"]). RESULTS: Median UPF intake (interquartile range [IQR]) among adolescents was 7.3% (IQR: 0, 17.2%) of daily kilocalories at age 11 y and 10.6% (IQR: 3.6, 19.6%) at 21 y. The odds and amount of adolescent UPF intake were positively associated with female sex, years of schooling, and household wealth and inversely associated with household size. The odds-but not amount-of adolescent UPF intake was positively associated with maternal education and urbanicity and inversely associated with the distance from a household's primary store/market. The association between odds of adolescent UPF intake and school enrollment was positive in adolescence but disappeared in early adulthood. Compared with offspring whose mothers did not consume UPFs, the odds of UPF intake among those whose mothers had low or high UPF intake was greater in adolescence, but there was no association once offspring became adults. At all ages, maternal UPF intake was positively associated with the amount of offspring intake. CONCLUSIONS: Adolescent UPF intake varied across sociodemographic characteristics and was positively associated with maternal UPF intake, but not after adolescents entered adulthood.

Food Vendors and the Obesogenic Food Environment of an Informal Settlement in Nairobi, Kenya: a Descriptive and Spatial Analysis.

Food environments of urban informal settlements are likely drivers of dietary intake among residents of such settlements. Yet, few attempts have been made to describe them. The objective of this study was to characterize the food environment of a densely-populated informal settlement in Nairobi, Kenya according to the obesogenic properties and spatial distribution of its food vendors. In July-August 2019, we identified food vendors in the settlement and classified them into obesogenic risk categories based on the types of food that they sold. We calculated descriptive statistics and assessed clustering according to obesogenic risk using Ripley's K function. Foods most commonly sold among the 456 vendors in the analytic sample were sweets/confectionary (29% of vendors), raw vegetables (28%), fried starches (23%), and fruits (21%). Forty-four percent of vendors were classified as low-risk, protective; 34% as high-risk, non-protective; 16% as low-risk, non-protective; and 6% as high-risk, protective. The mean distance (95% confidence interval) to the nearest vendor of the same obesogenic risk category was 26 m (21, 31) for vendors in the low-risk, protective group; 29 m (25, 33) in the high-risk, non-protective group; 114 m (88, 139) in the high-risk, protective group; and 43 m (30, 56) in the low-risk, non-protective group. Clustering was significant for all obesogenic risk groups except for the high-risk, protective. Our findings indicate a duality of obesogenic and anti-obesogenic foods in this environment. Clustering of obesogenic foods highlights the need for local officials to take action to increase access to health-promoting foods throughout informal settlements.

Household food insufficiency and flourishing in a nationally representative sample of young children in the U.S.

PURPOSE: This study examined the association between household food insufficiency and flourishing among young children (6 months-5 years) in the U.S. and assessed whether sleep adequacy modifies this association. METHODS: We used data from the 2018-2020 National Surveys of Children's Health. Adjusted prevalence differences and 95% confidence intervals (CI) for the association between household food insufficiency and flourishing were modeled using average marginal predictions from logistic regression models. Sleep adequacy was assessed as an effect measure modifier on the additive scale. RESULTS: Evidence supports additive scale effect measure modification of the food insufficiency-flourishing association by sleep adequacy (Likelihood Ratio Test statistic = 12.4, degrees of freedom = 2, P < .05). Adjusted for potential confounders, the prevalence of flourishing was 13.2 percentage points lower (95% CI: -22.6, -3.7) for children in households with insufficient food and inadequate sleep compared to those with sufficient food and adequate sleep. CONCLUSIONS: Our findings suggest that having enough food and enough sleep are associated with greater wellbeing. These modifiable factors should be targeted by public health interventions to facilitate flourishing among young children in the U.S.

Prevention Research Centers and COVID-19: Models of a Community-Engaged Response to a Public Health Emergency.

For more than 30 years, the network of Centers for Disease Control and Prevention (CDC)-funded Prevention Research Centers (PRCs) has worked with local communities and partners to implement and evaluate public health interventions and policies for the prevention of disease and promotion of health. The COVID-19 pandemic tested the PRC network's ability to rapidly respond to multiple, simultaneous public health crises. On April 28, 2020, to assess the network's engagement with activities undertaken in response to the early phase of the pandemic, PRC network leadership distributed an online survey to the directors of 34 currently or formerly funded PRCs, asking them to report their PRCs' engagement with predetermined activities across 9 topical areas and provide case studies exemplifying that engagement. We received responses from 24 PRCs, all of which reported engagement with at least 1 of the 9 topical areas (mean, 5). The topical areas with which the greatest number of PRCs reported engagement were support of frontline agencies (21 of 24, 88%) and support of activities related to health care (21 of 24, 88%). The mean number of activities with which PRCs reported engagement was 11. The PRCs provided more than 90 case studies exemplifying their work. The results of the survey indicated that the PRCs mobilized their personnel and resources to support the COVID-19 response in less than 6 weeks. We posit that the speed of this response was due, in part, to the broad and diverse expertise of PRC personnel and long-standing partnerships between PRCs and the communities in which they work.