Maternal Strategies to Access Food Differ by Food Security Status.

BACKGROUND: Household food insecurity is associated with health and behavior risk. Much less is known about how food insecurity is related to strategies that adults use in accessing food: how and where they shop, use of alternative food sources, and their ability to manage resources. OBJECTIVE: To examine how maternal behaviors, including shopping, accessing alternative sources of food, and managing resources, are related to household food security status (HHFSS). DESIGN: Cross-sectional study collecting survey data on HHFSS, shopping behaviors, use of alternative food sources, and managing resources obtained from low-income mothers of preschool-aged children. PARTICIPANTS: One hundred sixty-four low-income mothers of young children (55% Hispanic) from two communities in Rhode Island. MEASURES: HHFSS was measured using 10 items from the 18-item Core Food Security Module to assess adult food security. Mothers were surveyed about where, when, and how often they shopped; the strategies they use when shopping; their use of alternative sources of food, including federal, state, and local assistance; and their ability to manage their resources. STATISTICAL ANALYSIS: Analysis of variance and χ2 analyses assessed the associations between demographic variables, shopping, accessing alternative food sources, and managing resources, and HHFSS. Multivariate logistic regression assessed the associations between HHFSS and maternal demographic variables, food shopping, strategies, alternative sources of food, and ability to manage resources. RESULTS: Maternal age and language spoken at home were significantly associated with HHFSS; food insecurity was 10% more likely among older mothers (adjusted odds ratio [aOR] 1.10, 95% CI 1.03 to 1.17) and 2.5 times more likely among Spanish-speaking households (compared with non-Spanish speaking [aOR 3.57, 95% CI 1.25 to 10.18]). Food insecurity was more likely among mothers reporting more informal strategies (aOR 1.98, 95% CI 1.28 to 3.01; P<0.05) and perceiving greater inability to manage resources (aOR 1.60, 95% CI 1.30 to 1.98; P<0.05). CONCLUSIONS: The results suggest that low-income mothers use a variety of strategies to feed their families and that the strategies they use vary by HHFSS. Community nutrition programs and providers will need to consider these strategies when counseling families at risk for food insecurity and provide guidance to minimize the influence on healthy food choices.

Exploring Placentophagy in Humans: Problems and Recommendations.

Placentophagy, the practice of afterbirth ingestion among humans, has grown among middle-class, white women in Western societies. Although the reasons for placentophagy are varied, it is generally promoted as a means to help postpartum women stabilize mood, enhance recovery, and increase milk production. Virtually no studies have explored the effects of placentophagy on humans, and several researchers have called for studies examining the effects of human placentophagy. However, prior to examining the effects of placentophagy, a number of methodological issues need to be addressed. The present review explores research examining the effects of placentophagy in animals and humans and presents the theoretical assumptions behind placentophagy and its effects. Methodological issues related to placentophagy research are clarified, and existing research related to the nutritional and hormonal components of the placenta and their effects on milk production and postpartum depression are reviewed. Finally, implications and recommendations for future research are discussed.

Food- and health-related correlates of self-reported body mass index among low-income mothers of young children.

OBJECTIVE: To examine how income-related challenges regarding food and health are associated with variation in self-reported maternal body weight among low-income mothers. DESIGN: Cross-sectional design. SETTING: Two Northeastern cities. Seven day care centers and a Supplemental Nutrition Assistance Program outreach project. PARTICIPANTS: Sample of 166 mothers; 67% were overweight or obese, 55% were Hispanic, and 42% reported household food insecurity (HFI). MAIN OUTCOME MEASURES: Maternal self-reported height and weight to calculate body mass index (BMI). Independent variables were food program participation, supermarket use, 8-item food shopping practices scale, HFI, maternal depressive symptoms, and self-rated health. ANALYSIS: Hierarchical multiple regression analysis tested relationships between maternal BMI with the independent variables of interest, adjusting for demographic confounds. RESULTS: Shopping practices to stretch food dollars (P = .04), using community food assistance programs (P < .05), and HFI (P < .04) correlated with heavier maternal BMIs; higher self-rated health corresponded to lower BMIs (P = .004). CONCLUSIONS AND IMPLICATIONS: Some strategies low-income mothers use to manage food resources are associated with heavier BMIs. Nutrition educators, public health practitioners, and researchers need to collaboratively address the associations between these strategies, food insecurity, poor health, and unhealthy weight.

Assessment of Food Intake, Obesity, and Health Risk among the Homeless in Rhode Island.

OBJECTIVE: The objective of this study was to examine the relationship between the nutritional status, incidence of food insecurity, and health risk among the homeless population in Rhode Island. DESIGN AND SAMPLE: This correlational study utilized a convenience sample of 319 homeless adults from Rhode Island's largest service agency for the homeless. Information on use of services such as access to emergency foods, shelters, and the Supplemental Nutrition Assistance Program (SNAP) was requested. MEASURES: Food security was measured by the six-item subset of the USDA Food Security Core Module. Anthropometric measures included height, weight, and waist circumference. A 24-hr dietary recall was collected to determine the food intake for a subset of participants who agreed to supply this information (n = 197). CONCLUSION: Average dietary recall data indicated insufficient intake of vegetables, fruit, dairy, and meats/beans. It also indicated excessive intake of fats. Of the 313 participants, 29.4% were overweight and 39% were obese. Over 94% of the participants were food insecure, with 64% of this subset experiencing hunger. Fifty-five percent of the participants were currently receiving SNAP benefits. The majority of the sample was found to be food insecure with hunger.

Parent cognitive-behavioral intervention for the treatment of childhood anxiety disorders: a pilot study.

Strong evidence supports cognitive-behavioral therapy (CBT) for the treatment of childhood anxiety. Many studies suggest that parents play an etiological role in the development and maintenance of child anxiety. This pilot study examined the efficacy of a cognitive-behavioral intervention delivered to the parents of 31 anxious children (ages 7-13). Parents were randomly assigned to an individual parent-only CBT intervention (PCBT, n = 18) or wait-list control (WL, n = 13). PCBT demonstrated significant reductions in children's number of anxiety disorder diagnoses, parent-rated interference and clinician-rated severity of anxiety, and maternal protective behaviors at post-treatment, which were maintained at 3-months. WL did not demonstrate significant changes. There were no significant differences between conditions in child self-reported or parent-report of child anxiety symptoms. Findings were replicated in a combined sample of treated participants, as well as in an intent-to-treat sample. Parent-only CBT may be an effective treatment modality for child anxiety, though future research is warranted.

Associations between family food behaviors, maternal depression, and child weight among low-income children.

Although low-income children are at greater risk for overweight and obesity than their higher income counterparts, the majority of poor children are not overweight. The current study examined why such variation exists among diverse young children in poor families. Cross-sectional data were collected on 164 low-income, preschool aged children and their mothers living in two Rhode Island cities. Over half of the sample was Hispanic (55%). Mothers completed measures of family food behaviors and depression while trained assistants collected anthropometric data from children at seven day care centers and a Supplemental Nutrition Assistance Program outreach project. Multivariate analysis of covariance revealed that higher maternal depression scores were associated with lower scores on maternal presence when child eats (P < .05), maternal control of child's eating routines (P < .03), and food resource management skills (P < .01), and with higher scores on child control of snacking (P < .03) and negative mealtime practices (P < .05). Multiple regression results revealed that greater maternal presence whenever the child ate was significantly associated with lower child BMI z scores (ß = .166, P < .05). Logistic regression analyses indicated that higher scores on food resource management skills reduced the odds of child overweight (odds ratios = .72-.95, P < .01). Maternal depression did not modify the relationship between family food behaviors and child weight. Overall, caregiver presence whenever a child eats, not just at meals, and better parental food resource management skills may promote healthier weights in low-income preschoolers. Further research is needed to identify the mechanisms that connect caregiver presence and food resource management skills to healthier weights for this age group.

A longitudinal study of WIC participation on household food insecurity.

We examined the association between women's/children's duration of WIC participation and household food security status. For mothers (n = 21,863) and their children (n = 57,377) participating in WIC (2001-2006), longitudinal measures of household food security status were collected using a subscale of the USDA Food Security Module. Using logistic regression, household food security status at the last WIC visit was associated with measures of WIC duration (number of trimesters on WIC for pregnant women, and number of WIC visits for children). Among women with prenatal household food insecurity with hunger, odds of any post-partum household food insecurity was reduced with first (AOR = 0.67, 95% CI = 0.48-0.94) or second trimester of entry (AOR= 0.64, 95% CI = 0.45-0.90) versus third. Among children with initial household food insecurity without hunger, an additional WIC visit reduced the odds of any household food insecurity (AOR = 0.92, 95% CI = 0.90-0.94) and of household food insecurity with hunger (AOR = 0.94, 95% CI = 0.89-0.98) at the last visit. Among those with initial household food insecurity with hunger, an additional WIC visit reduced the odds of any household food insecurity (AOR = 0.96, 95% CI = 0.92-0.99) and of household food insecurity with hunger (AOR = 0.88, 95% CI = 0.83-0.94) at the last visit. Earlier and longer WIC participation may improve household food security status, particularly of vulnerable groups.

Measuring family food environments in diverse families with young children.

This study reports the development and validation of the 20 item Family Food Behavior Survey, a measure designed to assess broad components of the family food environment that may contribute to child overweight. In a diverse sample of 38 parents, factor analyses verified 4 domains: (1) maternal control of child eating behavior; (2) maternal presence during eating; (3) child choice, and (4) organization of eating environment. All domains achieved acceptable internal reliability (alphas= .73, -.83), and test-retest reliability. Mothers of overweight children scored significantly lower on maternal presence and somewhat higher on maternal control than mothers of normal weight children.

Subclinical prenatal iodine deficiency negatively affects infant development in Northern China.

Although mild-to-moderate levels of iodine deficiency (ID) have been associated with poor cognitive outcomes in children, little is known about subclinical prenatal ID and infant development. In this study, the association between elevated cord blood thyroid stimulating hormone (TSH, thyrotropin) and infant development was examined in Northern China. Three groups of infants with elevated cord blood TSH were compared with infants with normal TSH levels on an information processing task at 7 mo, and in cognitive and motor developmental assessments at 13 mo. Infants with elevated TSH had poorer information processing skills and lower scores on the cognitive development index. There were no differences in motor abilities. Relationships between socioenvironmental factors and iodine status were assessed. Infants from more rural settings and those whose mothers had completed fewer years of schooling and had lower paying occupations had higher cord blood TSH levels. A regression analysis indicated that maternal education was predictive of cognitive performance among infants with elevated TSH but not control infants. The findings suggest that subclinical prenatal ID has negative effects on infant development and that, in some instances, maternal education may ameliorate these effects.