To dine in or not to dine in: A comparison of food selection and preparation behaviours in those with and without food security.

ISSUE ADDRESSED: Vulnerable populations are disproportionately affected by food insecurity, resulting in heightened risk of suboptimal dietary intake. Food insecure people appear to implement several coping strategies and dietary compromises to avoid hunger. Less explored in the literature is how these strategies impact consumption of food inside and outside of the home. METHODS: An online survey was completed by adults (n = 1292) residing in one of five Australian states. The questionnaire comprised of the six-item US Household Food Security Survey Module, 12 socio-demographic variables and 32 questions related to elements of food literacy. RESULTS: Food insecure respondents were more likely to frequent fast food vs (P = .002), takeaway (P < .001) and food courts (P < .001) than their food secure counterparts. Food secure respondents reported greater use of raw (P = .043) and fresh, pre-prepared produce (P = .002) when cooking, whereas food insecure respondents were more likely to prepare food using only frozen, pre-packaged products (P < .001). No significant differences were found between food security status and the enjoyment and social bonding derived from cooking. CONCLUSIONS: Food insecure respondents appeared to be accessing a poorer quality of food through greater consumption of takeaway and fast food. These dietary compromises are most likely related to perceived financial, time or cooking facility constraints and to a lesser extent food literacy skills. SO WHAT?: This study highlights some of the health and social inequities apparent within food insecure populations. Food insecure households should be supported to access healthy fresh food and in-home cooking practices. While a multi strategy approach is required, healthy food environment policy, particularly in disadvantaged areas, should be considered to guarantee that all Australians have dignified access to nutritious food.

Utilising a multi-item questionnaire to assess household food security in Australia.

ISSUE ADDRESSED: Currently, two food sufficiency questions are utilised as a proxy measure of national food security status in Australia. These questions do not capture all dimensions of food security and have been attributed to underreporting of the problem. The purpose of this study was to investigate food security using the short form of the US Household Food Security Survey Module (HFSSM) within an Australian context; and explore the relationship between food security status and multiple socio-demographic variables. METHODS: Two online surveys were completed by 2334 Australian participants from November 2014 to February 2015. Surveys contained the short form of the HFSSM and twelve socio-demographic questions. Cross-tabulations chi-square tests and a multinomial logistic regression model were employed to analyse the survey data. RESULTS: Food security status of the respondents was classified accordingly: High or Marginal (64%, n = 1495), Low (20%, n = 460) or Very Low (16%, n = 379). Significant independent predictors of food security were age (P < 0.001), marital status (P = 0.005), household income (P < 0.001) and education (P < 0.001). CONCLUSION: Findings suggest food insecurity is an important issue across Australia and that certain groups, regardless of income, are particularly vulnerable. SO WHAT?: Government policy and health promotion interventions that specifically target "at risk" groups may assist to more effectively address the problem. Additionally, the use of a multi-item measure is worth considering as a national indicator of food security in Australia.

Australian Consumers Are Willing to Pay for the Health Star Rating Front-of-Pack Nutrition Label.

The Australia and New Zealand Ministerial Forum on Food Regulation has supported the recommendations set out in the 2019 Health Star Rating System Five Year Review Report. Specifically, the forum supported, in principle, Recommendation 9, to mandate the Health Star Rating if clear uptake targets were not achieved while the system is voluntary. Given that mandatory labelling is being considered, it is important to investigate how much consumers value the Health Star Rating in order to understand potential consumer uptake and inform industry. The aim of this study was to assess consumers' valuation of the Health Star Rating system by analysing their willingness to pay for a packaged food product with the Health Star Rating label, utilising a double-bounded dichotomous choice contingent valuation approach. The results indicate that almost two-thirds of Australian household grocery shoppers were willing to pay more for a product with the Health Star Rating, on average up to an additional 3.7% of the price of the product. However, public health nutrition benefits associated with consumers' willingness to pay more for products with the Health Star Rating is currently limited by the lack of guarantee of the systems' accuracy. Given consumer support, a well validated and comprehensive Health Star Rating labelling system can potentially improve health outcomes, cost effectiveness and reduce environmental impacts.

Food-Insecure Household's Self-Reported Perceptions of Food Labels, Product Attributes and Consumption Behaviours.

Dietary compromises related to food insecurity profoundly undermine health and constitute a serious public health issue, even in developed nations. The aim of this study was to explore the impact of food labelling and product attributes on the purchasing choices of food-insecure households in Australia. An online survey containing 19 food choice and 28 purchasing behaviours questions was completed by 1056 adults responsible for household grocery shopping. The short form of the US Household Food Security Survey Module was used as the food security indicator. Multinomial logistic regression modelling was employed to analyse the survey data. Respondents were classified as having either high-marginal (63.4%, n = 670), low (19.8%, n = 209) or very low (16.8%, n = 177) food security. Respondents with low or very low food security status were less likely to self-report understanding the information on the back of packaging (p < 0.001), find information on food labels useful (p = 0.002) or be influenced by product nutrition information (p = 0.002). Convenience (p < 0.001), organic (p = 0.027) and supermarket-branded products (p < 0.001) were more likely to be rated as important by food-insecure respondents when compared to their food-secure counterparts. When asked to rate "how healthy" their diet was, high-marginal FS respondents were twice as likely describe their diet as healthy than very low FS respondents (p = 0.001).

What Drives Food Insecurity in Western Australia? How the Perceptions of People at Risk Differ to Those of Stakeholders.

Food insecurity is considered a "wicked" problem due to the highly complex and at times undefined casual factors. Although many stakeholders are working to address the problem, a possible divergence exists between their views on food insecurity and those of the people who are actually experiencing the problem. The purpose of this study was to investigate whether there was a difference between the opinions of those "at risk" and stakeholders. A total of seven focus groups (two stakeholder groups n = 10, five "at-risk" groups n = 34) and three interviews (stakeholders n = 3) were conducted to ascertain perceptions. Thematic analysis generated 329 (209 "at-risk" and 120 stakeholder) coded statements related to food insecurity drivers. Respondents were in agreement for the majority of factors, and limited income was considered the primary driver of food insecurity. However, there were notable deviations in the perceived importance of certain drivers, particularly around the price of food and the lack of food literacy. Differences in the perception of causes of food insecurity may in part be attributed to the varied role each group plays in working towards the resolution of the problem, either at the household or system level.