Trauma exposure proximity associated with eating disorder diagnosis in women with food insecurity.

Trauma exposure is a risk factor for both food insecurity (FI) and increased eating disorder (ED) pathology. The purpose of this study was to explore the relation between trauma and ED diagnosis in a sample of women experiencing FI. A cross-sectional analysis of surveys from 99 women with self-reported FI (54% White; mean [SD] age = 40.26 [14.33] years) in the United States was employed. Participants completed online surveys including the Life Events Checklist (LEC) questionnaire, General Anxiety Disorder-7, Patient Health Questionnaire-9, and an interview comprised of the Household Food Security Survey Module (HFSSM) and Eating Disorder Diagnostic Interview (EDDI). LEC traumatic events were weighted by proximity: events experienced directly were weighted by a factor of 3, witnessed by 2, learned about by 1, and summed to a total weighted score. ED diagnosis in the past 12 months was assessed via the EDDI using DSM-5 diagnostic criteria. A binary logistic regression model tested associations between weighted trauma score, FI, and ED diagnosis. Weighted trauma score significantly predicted any ED diagnosis (OR = 1.039, p = .016), but FI severity did not (OR = .746, p = .101). These results suggest trauma proximity predicts ED diagnosis beyond that of FI severity and may be an important component of the association between FI and ED pathology. Future work may consider evaluating longitudinal symptoms of trauma and trauma severity in relation to FI.

Food insecurity and the consumption of plant-centered meals and high sodium foods among students at three large state universities.

Objective: To examine the associations between food insecurity and plant-centered meal consumption and other sodium-related dietary behaviors among university students. Methods: A web-based survey of students at three California state universities was conducted between August 2018 to May 2019. Multivariable logistic regressions examined the associations between food insecurity and four sodium-related dietary behaviors. Interaction terms were introduced to assess if race/ethnicity moderated these associations. Results: High food insecurity was associated with increased odds of reporting 'likely to order' plant-centered meals (AOR = 1.55, 95% CI = 1.16-2.05). Moderate food insecurity was associated with increased odds of frequently eating processed foods (AOR = 1.40, 95% CI = 1.13-1.74). No moderation effects were found for race/ethnicity. Conclusions: University students with high food insecurity appeared receptive to ordering plant-centered meals, whereas those with moderate food insecurity consumed more processed foods. State universities should encourage and offer more low-sodium, plant-centered meal options in their food venues, on- and off-campus, to promote student health.

Maternal perceived stress, household disorder, eating behaviors and adiposity of women and their children.

BACKGROUND: Stress is associated with physiological and behavioral adaptations that increase the risk for obesity and related diseases in adults and children. Mechanisms linking stress to chronic disease are diverse and not fully elucidated, but research suggests stress may impact eating behaviors and increase food intake and thereby, risk for obesity. OBJECTIVE: The purpose of this study was to test the hypotheses that women's perceived stress and household disorder are associated with more uncontrolled and emotional eating among women, more food responsiveness and emotional overeating among their children, and greater adiposity in both women and their children. METHODS: Women (n = 86) completed the Perceived Stress Scale, Confusion, Hubbub and Order Scale, Three Factor Eating Questionnaire, and Child Eating Behavior Questionnaire. Total body fat (%) was measured via dual-energy X-ray absorptiometry. Linear regression models evaluated associations of perceived stress and household disorder with eating behaviors and adiposity of women and their children (4-10 years old). RESULTS: In a sample of predominantly non-Hispanic Black women (84.9%, n = 73), more perceived stress and household disorder were associated with more uncontrolled and emotional eating (p < 0.05). Women's perceived stress was not associated with their children's eating behaviors; however, household disorder was positively associated with children's food responsiveness and emotional overeating (p < 0.05). Perceived stress and household disorder were not associated with adiposity of women or their children. CONCLUSIONS: These findings suggest household disorder may be a factor for home-based interventions to consider when addressing eating behaviors among families with children.

Navigating social determinants of health barriers in the management of phenylketonuria.

Phenylketonuria (PKU) is an inborn error of amino acid metabolism that is typically identified by newborn screening. With lifelong treatment consisting of dietary management, frequent laboratory monitoring, and regular metabolic clinic visits, patients with PKU can maintain good health and metabolic control. Here, we describe the case of an 8-year-old patient with PKU who has been followed by a metabolic clinic since birth. Despite responsiveness to sapropterin, this patient has had periods of poor metabolic control throughout her life due to her family's economic hardships, including limited access to transportation, housing, food, and health insurance. This case illustrates how social determinants of health may negatively affect rare disease management and potential strategies for addressing barriers to care.

Associations Between Social Determinants of Health and Outcomes of Chronic Medical Conditions.

Social determinants of health, such as food insecurity, can significantly impact patient welfare, potentially increasing the prevalence of chronic illnesses while hindering their management, as shown in previous data collected by the National Health and Nutrition Examination Survey. This study aimed to investigate the association between food insecurity and other social determinants of health with hyperlipidemia, type 2 diabetes mellitus (T2DM), and hypertension. To that end, self-reported data on food security from clinical encounters and biological data from medical records were collected. This study utilized electronic medical record data from 349 patients aged between 18 and 85 years who answered two standard food insecurity screening questions. Each patient's current diagnoses and lab values, including blood pressure, fasting low-density lipoprotein (LDL) cholesterol, and hemoglobin A1c (HbA1c), were then collected. Among patients facing food insecurity (n = 48), 55% were diagnosed with hypertension (p = 0.019), 45% with hyperlipidemia, and 27% with T2DM (p = 0.005). By comparison, these values for food-secure patients were 39%, 54%, and 13%, respectively (n = 301, p > 0.05). Regarding control of these chronic illnesses, hypertension (defined as blood pressure >135/85 mmHg per American Academy of Family Physicians (AAFP) guidelines) was observed in 12% of food-secure patients (n = 301, p > 0.05) and 42% of food-insecure patients (n = 48, p = 0.0204), whereas differences in control of hyperlipidemia and T2DM were insignificant. These results suggest that food-insecure patients are more likely to be diagnosed with hypertension and T2DM but are less likely than food-secure patients to be diagnosed with hyperlipidemia. Consistent with previous research, this study highlights the potentially increased health risks for patients experiencing food insecurity and calls for further efforts to screen patients for social determinants of health.

Exploring Food Insecurity and Perceived Stress on Daytime Sleepiness among Older Adults in New York City.

The growing population of older adults in the U.S. is experiencing increased food insecurity and stress, which are associated with nocturnal sleep quality and consequently excessive daytime sleepiness. This study aimed to investigate the relationship between food insecurity and perceived stress on daytime sleepiness in older adults aged 60 and older living in New York City. This cross-sectional, quantitative study utilized the US Household Food Security Survey Module six-item questionnaire, the Perceived Stress Scale (PSS), and Sleepiness Total to collect data. Participants completed an online survey via Qualtrics. Linear and logistic regression models were used to assess the association between demographic variables and food insecurity, perceived stress, and daytime sleepiness outcomes. Three hundred seventy-eight (378) older adults participated in this study. Food insecurity was associated with age (p = 0.045), education (p = 0.022), and daytime sleepiness (p < 0.001). On average, participants with a BMI of over 30 had an increased daytime sleepiness total relative to a BMI < 25 (p = 0.029), and those with two to three health conditions and those with more than four health conditions had higher daytime sleepiness totals relative to those with zero to one condition (p = 0.007 and 0.007, respectively). Participants who had moderate and high stress, regardless of food security status, had higher daytime sleepiness totals than those with low stress (food secure; p = 0.002; food insecure; p < 0.001). Multifaceted interventions are needed to alleviate food insecurity, manage stress, and reduce excessive daytime sleepiness among older adults.

Household food insecurity and symptoms of anxiety and depression during pregnancy: Systematic review and meta-analysis.

Household food insecurity (HFI) has been related to adverse maternal-child health outcomes and mental health worsening during pregnancy. Few studies evaluated the temporal association between HFI and anxiety and depressive symptoms in pregnant women, and this association remains not completely understood. This study aimed to systematically review the association between HFI and symptoms of depression and anxiety in pregnant individuals. The systematic review protocol was registered in the International Prospective Register of Systematic Reviews (CRD42022373615). Systematic searches were conducted on 10 electronic databases and grey literature. Two researchers independently conducted the study selection, data extraction process, and the risk of bias assessment. Random-effects meta-analysis models were used, and I2 > 40% indicated high heterogeneity across studies. Eighteen articles were included for the systematic review, comprising n = 27,882, and a total of 18,987 pregnant individuals aged between 14 and 45 years were included in the meta-analysis. The prevalence of HFI reported in studies ranged from 12.6% to 62.1% (n = 17). The prevalence of depressive and anxiety symptoms ranged from 18% to 49% (n = 11) and 23% to 34% (n = 2), respectively. HFI during pregnancy was associated with increased odds of experiencing symptoms of depression [(OR: 2.52; 95% CI: 2.11-3.02), I2 = 73.23%]. The quality of evidence was very low due to high heterogeneity. Our findings highlighted the association between HFI and depression symptoms during pregnancy. Findings from this study suggest the importance of assessing HFI and mental health during pregnancy.

Children's Educational Attainment and Older Parents' Food Insecurity: Evidence From India.

Objectives: To examine the relationship between children's educational attainment and the risk of food insecurity among older parents and to determine if this relationship varies by the sex and residence of the children. Methods: This study utilized data from the Longitudinal Ageing Survey in India (LASI, 2017-18), comprising 25,914 individuals aged 60+ with at least one living child. Logistic regression, interaction analysis, and propensity score matching were employed to achieve the study's objectives. Results: Having a child with higher education (undergraduate or above) was associated with a 35% reduction in the odds of parents experiencing food insecurity. This negative relationship was significant for both sons' and daughters' education, with daughters' education having higher effect size. Conclusion: In a country like India, characterized by a weak welfare system but a strong collectivist family culture, children's education may play an important role in ensuring older parents' food security.

A systematic comparison of additive and interaction approaches to modeling the effects of syndemic problems on HIV outcomes in South Africa.

Much of the research on the effects of syndemics on HIV outcomes has utilized an additive approach. However, interaction effects may better account for syndemic synergy than an additive approach, but it remains difficult to specify interaction effects without empirical guidance. We sought to systematically compare additive and interaction effects approaches to modeling the effects of syndemic problems on antiretroviral therapy (ART) using empirically specified interaction terms. Participants were 194 people with HIV (PWH) who received HIV care in Khayelitsha, South Africa. In a series of linear regression models, we examined ten syndemic problems: depression, alcohol use, intimate partner violence (IPV), post-traumatic stress, social anxiety, substance use, food insecurity, poverty, housing instability, and structural barriers to care. Depression, substance use, and food insecurity were selected for interaction terms based on a prior network analysis, which found these problems to be most central. The additive models did not produce statistically significant findings. However, the interaction effects models yielded significant interaction terms in both the full model and a parsimonious model. There was a statistically significant effect of the interaction between depression and food insecurity on ART adherence (b = 0.04, Robust SE = 0.02, 95%CI [0.001-0.08], p = .012). This pattern of results was replicated in the parsimonious model. Findings suggest that when feasible, interaction effects approaches may be a helpful syndemic modeling technique. Results may inform future intervention targets, such as depression and food insecurity, and the importance of addressing both structural and psychosocial syndemic problems.

Impact of a school-based intervention and the COVID-19 pandemic on healthy eating in Navajo families: Results from the Yéego! Healthy eating and gardening intervention trial.

Objectives: As part of a group randomized trial of a school-based intervention promoting gardening and healthy eating, health behaviors of adult family members were evaluated. The COVID-19 pandemic hit the Navajo Nation in March 2020 and the ongoing Yéego! collaborative study allowed description of adult response to COVID as an ancillary objective. Methods: Six elementary schools on the Navajo Nation in Arizona or New Mexico had been randomized to intervention or comparison group. One adult family member for each 3rd and 4th grade student completed surveys at baseline, nine-month and 21-month follow-up. Adult outcomes were fruit and vegetable (F&V) intake, obesogenic dietary index and gardening frequency. COVID-related measures were collected at 21-month follow-up. Differential changes and interactions were examined using repeated measures linear mixed models. Results: Adult F&V intake increased significantly more in the intervention group than in the comparison group at nine months by 2.26 servings/day (95% CI: 0.45, 4.06). No other changes were associated with the intervention at nine or 21 months. At 21 months, in the subgroup with COVID concerns, the differential change in F&V intake was 2.02 (95% CI: 0.21, 3.84) servings/day. In cross-sectional analyses, only healthy eating measures varied by levels of COVID concerns, stress and resilience. Conclusions: The child focused school-based intervention had some impact on adult family members, particularly their F&V intake, suggesting the reach of the intervention extended to students' families. The impact on adult F&V intake persisted among those reporting COVID concerns. Findings have important implications for augmenting healthy eating interventions.

The association of food insecurity with non-alcoholic fatty liver disease (NAFLD) in a sample of Iranian adults: a path analysis of a cross-sectional survey.

OBJECTIVES: The present study aims to examine the hypothetical model of the relationship between food insecurity and Non-alcoholic fatty liver disease (NAFLD) in a sample of Iranian adults. METHODS: In this cross-sectional study, 275 subjects (18-70 years old) who met the inclusion criteria were recruited. Fatty liver was diagnosed by abdominal ultrasonography, and eligible patients underwent liver fibro scan assessment to determine fibrosis and steatosis. Food insecurity was assessed using the validated six-item Short Questionnaire of Household Food Security Scale (SQHFSS). Data were analyzed using SPSS 24.0 and IBM SPSS Amos 24.0. RESULTS: Among 275 subjects (44.37 ± 11.67 years old, 51.6% male) included in the analysis, 23.6% were food insecure. Food insecurity, general and abdominal obesity were associated with an increased risk of NAFLD, even after multiple adjustments (OR: 2.95, 95% CI: 1.02, 8.57; OR: 3.27, 95% CI: 1.50, 7.11; and OR: 3.81, 95% CI: 1.55, 9.32, respectively). According to the primary hypothesis, food insecurity and NAFLD were fitted into a model (χ2/df = 1.36, GFI = 0.982, AGFI = 0.952, CFI = 0.954, IFI = 0.959, SRMR = 0.040, RMSEA = 0.037); accordingly, food insecurity and obesity (general and abdominal) directly affected NAFLD (ß = 0.12, P = 0.03; ß = 0.13, P = 0.02; ß = 0.31, P < 0.001, respectively). CONCLUSION: Food insecurity was a predictor of, and directly associated with, NAFLD. Social determinants should be considered in the pathogenesis of NAFLD, although the possible underlying biological mechanisms in this association are yet to be determined.

The relationship between food insecurity, purchasing patterns and perceptions of the food environment in urban slums in Ibadan, Nigeria.

BACKGROUND: Rapid urbanisation without concomitant infrastructure development has led to the creation of urban slums throughout sub-Saharan Africa. People living in urban slums are particularly vulnerable to food insecurity due to the lack of physical and economic accessibility to food. Hence, it is important to explore how vulnerable groups living in slums interact with the food environment. This study assessed the relationships between food insecurity, including restrictive coping strategies, food purchasing patterns and perceptions about the food environment among dwellers of selected urban slums in Ibadan, Nigeria. METHODS: This community-based cross-sectional study was conducted with people responsible for food procurement from 590 randomly selected households in two urban slums in Ibadan. Food insecurity and restrictive coping strategies were assessed using the Household Food Insecurity Access Scale and the Coping Strategy Index, respectively. We examined purchasing patterns of participants by assessing the procurement of household foodstuffs in different categories, as well as by vendor type. Participants' perceptions of the food environment were derived through a five-item composite score measuring food availability, affordability and quality. Chi-square tests and logistic regression models analysed associations between food insecurity, purchasing patterns and perceptions of the food environment. RESULTS: The prevalence of food insecurity in the sample was 88%, with 40.2% of the households experiencing severe food insecurity. Nearly a third (32.5%) of the households used restrictive coping strategies such as limiting the size of food portions at mealtimes, while 28.8% reduced the frequency of their daily meals. Participants purchased food multiple times a week, primarily from formal and informal food markets rather than from wholesalers and supermarkets. Only a few households grew food or had livestock (3.2%). Food insecure households had a lower perceived access to the food environment, with an approximate 10% increase in access score per one-unit decrease in food insecurity (AOR = 0.90, 95% CI: 0.84, 0.96). The most procured foods among all households were fish (72.5%), bread (60.3%), rice (56.3%), yam and cassava flours (50.2%). Food-secure households procured fruit, dairy and vegetable proteins more frequently. CONCLUSION: Food insecurity remains a serious public health challenge in the urban slums of Ibadan. Perceptions of greater access to the food environment was associated with increasing food security. Interventions should focus on creating more robust social and financial protections, with efforts to improve livelihoods to ensure food security among urban slum-dwellers.

Social support for food access and budget construction predict food insecurity among university sophomores.

Background: Food insecurity means having limited or uncertain access to an adequate, nutritious, and safe diet. Rates among US college students range from 10% to 75%, and the problem is associated with mental and physical health disorders and unfavorable academic outcomes. Aims: This study examined the associations between the food security status of sophomores attending a university in the Southeastern US and their need for social support, food access behaviors, and budgeting knowledge. Methods: Data were collected during the spring 2019 semester using an online questionnaire. Food security was measured using the United States Department of Agriculture (USDA) Food Security Survey, and the independent variables were measured from scales grounded in pertinent literature. Descriptive and inferential procedures were applied, and significance was p ≤ 0.05. Results: Participants were 222 sophomores (75% female and 85% white). Food insecurity was 46.4%, and significant predictors (p < 0.001) were need for social support accessing food and the requested educational activity "learning how to make a budget." Mean budgeting knowledge scores of food secure and insecure students, respectively, were 11.5 ± 1.8 versus 11.1 ± 2.4 (p = 0.42) out of 14 points. Food access behaviors used "sometimes" or "often" by food secure and insecure sophomores included buying food on sale and buying the store brand of a food, while creating a budget that includes food purchases and getting free food from food pantries were "seldom" or "never" used. Conclusions: Food insecurity was high. Learning activities, such as budgeting education, should be tested as strategies for decreasing food insecurity.

Food Insecurity Prevalence and Risk Factors among Persons with HIV in a Southeastern US Clinical Care Setting.

Food insecurity (FI) is associated with adverse health outcomes for persons with HIV (PWH). Little is known about FI among PWH in southern or non-urban settings. We examined FI prevalence, risk factors, and access to services in a southeastern HIV clinic. Among PWH in the UNC CFAR HIV Clinical Cohort who were screened for FI as part of HIV care between 2021 and 2022, we estimated unadjusted prevalence ratios (PRs) comparing the probability of reporting FI by demographic and clinical characteristics. The 479 PWH screened for FI were 65% cisgender men, 62% non-Hispanic Black PWH, a median of 54 years old (IQR 41-62), and 93% with an HIV viral load (VL) < 200 copies/mL. FI prevalence was 36.3% (95% CI 32.3%-40.9%). Cisgender women and transgender adults were more likely to report FI than cisgender men (PRs 1.24 [95% CI 0.97-1.59] and 2.03 [1.32-3.12], respectively). Compared with White PWH, the PR was 1.71 (1.20-2.42) for Black and 2.44 (1.56-3.82) for Hispanic PWH. The PR was 1.42 (0.98-2.05) for PWH with VL ≥ 200 versus < 200 copies/mL. Having no or public versus private health insurance was also associated with FI. PWH with FI had a high prevalence of comorbidities including hypercholesterolemia (49%) and hypertension (48%), though these were not associated with FI. Almost half of PWH with FI were not accessing a food pantry or nutrition assistance program. Identifying FI in PWH is critical as FI is common and may contribute to viral non-suppression, poor comorbidity control, and gender and racial/ethnic health disparities in PWH.

Is in-kind kinder than cash? The impact of money vs. food aid on social emotions and aid take-up.

Over the past decade, there has been a shift in the way charities deliver humanitarian aid. Historically, the most prevalent way to help the global poor was by providing in-kind asset transfers. Recently, alternatives to in-kind aid, such as cash aid, have been increasing in prevalence. Although there has been widespread endorsement from the academic community and the public on the popularizing model of giving cash aid, one perspective remains untouched: the recipient's perspective. Thus, the present research explores how food-insecure individuals feel when receiving money vs. in-kind food aid to help meet their hunger and nutrition needs. Specifically, we explore the degree of positive (e.g., feeling cared for) and negative (e.g., feeling ashamed) social emotions felt when receiving the aid opportunity and how willing recipients are to accept monetary (vs. food) aid. Results from five preregistered experiments (N = 3,110)-a field experiment in Kenya and four online experiments in the United States-find that monetary (vs. food) aid elicits comparatively more of a market-pricing relationship and less of a communal sharing relationship and, hence, makes people feel less positive and more negative social emotions when receiving the help. Subsequently, recipients are less likely to take up monetary (vs. food) aid from a charity. However, we find that this effect does not persist when receiving government aid: Recipients are similarly willing to accept money and in-kind food aid from the government. This research suggests that future scholarship ought to examine ways to improve psychological experiences when receiving money from charity.

Firearm Homicide Mortality is Linked to Food Insecurity in Major US Metropolitan Cities.

BACKGROUND: Gun violence disproportionately affects metropolitan areas of the United States (US). There is limited information regarding the influence of social determinants of health, such as food insecurity (FI) on firearm homicide mortality (FHM) in major metropolitan cities in the US. We sought to examine the relationship between FI and FHM. MATERIALS AND METHODS: This was a cross-sectional analysis examining the largest 51 US major metropolitan statistical areas (MSAs) using data from 2018. Demographic data, markers of social inequities, and firearm homicide data were obtained from the US Census Bureau, US Department of Education, and the Frey and Brookings Institute. Food insecurity prevalence was obtained from Feeding America. Spearman ρ and linear regression were performed. RESULTS: Using Spearman rho analysis, higher FI (r = 0.55, P < 0.001) was associated with FHM. Other variables associated with FHM included percent Black/African American (AA) (r = 0.77, P < 0.001), poverty rate (r = 0.53, P < 0.001), and percent of children living in single parent households (r = 0.58, P < 0.001). In linear regression analyses, FI was associated with increased FHM, with 1.3 additional FHM events for each unit increase in FI (ß = 1.33, 95% CI 0.27-2.39, P = 0.02). The percent of a population that is Black/AA was also associated with FHM, with more than 4 additional cases for each 1% increase in the population (ß = 4.32, 95% CI 3.26-5.38, P < 0.001). CONCLUSION: Food insecurity may influence FHM in major US metropolitan cities. Community- and hospital-based programs that target FI may help combat the gun violence epidemic and decrease gun violence.

Revising a right to food road map-perspectives of Australian key informants.

OBJECTIVE: In Australia, an estimated 1 in 10 households experiences food insecurity. The objective of this study was to devise a visual synthesis to summarise the activities, processes and principles that support the right to food for everyone in Australia. METHODS: Semi-structured key informant interviews (n=30) were conducted during 2019-20. Content analysis synthesised perspectives and assisted co-authors in revising an initial draft (shared during the interview) to finalise the road map through semantic realist data analysis and re-design. RESULTS: The six components of the right to food road map summarise the actions, processes, and principles to address the human right to food. These include i) policy leadership, ii) advocate and enact, iii) empowerment, iv) resourcing, v) monitoring and accountability and vi) healthy, equitable and sustainable food systems. CONCLUSIONS: When all the right to food actions, processes and principles are present, the "cogs" within the map are hypothesised to interact and realise the right to food for all Australians. IMPLICATIONS FOR PUBLIC HEALTH: Considering the cost of living pressures and unrelenting demand for food relief, better solutions are needed for food insecurity. Human rights - this language, their international recognition and as a "method of working", offer an alternative to the dominant responses to food insecurity.

"I have to pick my battles": a mixed-methods study exploring food insecurity and dietary restrictions in pediatric kidney disease.

BACKGROUND: Food insecurity (FI) is prevalent among children with chronic kidney disease (CKD), but its impact on health outcomes, and feasibility of prescribed diet restrictions is unknown. Accordingly, this study aims to explore associations of FI and CKD outcomes, and understand its role in following prescribed kidney diet recommendations. METHODS: We performed a mixed-methods single-center cohort study of children with advanced CKD or kidney failure. Demographics, socioeconomic status, and health outcomes were compared across FI status; associations between FI and CKD outcomes were explored using multivariable regression. A qualitative sub-analysis of de-identified caregiver interview transcripts was analyzed for themes around diet restrictions. RESULTS: There was a trend that FI patients were more likely to be of Black race (33% vs. 20%); have public insurance (67% vs. 48%); need more blood pressure medications (2 [0.75,3] vs. 1 [0,3]); and have a higher likelihood of emergency department (42% vs. 25%) or intensive care unit encounters (25% vs. 14%). There were no associations of FI and outcomes of interest. Major themes that emerged from caregiver interviews include (1) understanding of the kidney diet focuses on foods to avoid; (2) adapting to suggested dietary restrictions requires changes in meal preparation; and (3) challenges to adherence include social stigma, growth, budget, and time. CONCLUSIONS: The impact of FI on children's medical needs with CKD remains inconclusive but trends suggest a higher risk. Regardless of FI status, adhering to prescribed diet restrictions in kidney disease involves significant dedication. Challenges involve food availability, a child's response to restrictions, and social stigma.

Food Insecurity Knowledge and Training Among College Students in Health Majors.

OBJECTIVE: To describe current food insecurity (FI)-related training among nutrition/dietetics, public health, and social work students. METHODS: A cross-sectional online survey was used among students (n = 306) enrolled in health-related programs at 12 US universities. Participants reported FI-related course-based and extracurricular experiences and rated confidence to address FI on a scale of 1-3. Open-ended questions investigated perceived definitions of FI and impactful course activities. Descriptive statistics and thematic analysis were used for data analysis. RESULTS: Participants' FI definitions were multifaceted. Most (80.6%) reported FI being covered in at least 1 course. The overall mean confidence to address FI was 2.2 ± 0.48. Participants suggested increasing application-based opportunities and skills training. CONCLUSIONS AND IMPLICATIONS: Most students have a basic understanding of FI and report high confidence to address it in the future. Impactful FI-related experiences and participants' suggestions guide developing an FI training resource to enhance student FI competency and sensitivity.

Rift Valley Fever Epizootic, Rwanda, 2022.

A Rift Valley fever epizootic affected livestock in Rwanda during March-October 2022. We confirmed 3,112 infections with the virus, including 1,342 cases, 1,254 abortions, and 516 deaths among cattle, goats, and sheep. We recommend a One Health strategy for investigations and response to protect animal and human health.