Intergenerational Food Insecurity, Underlying Factors, and Opportunities for Intervention in Momostenango, Guatemala.

Achieving sustainable food security in Guatemala, where nearly half the population is food insecure and 50% of children face chronic malnutrition, is challenging. This mixed-methods study aimed to identify the impacts of climate change on food production, community food security, and household food security. Twelve agricultural group leaders in six communities were interviewed using semi-structured guides. Key informant interview themes included subsistence agriculture, commercial production, challenges related to climate, capital, market, and capacity, as well as sustainable opportunities. Fifty-five mothers from 13 distinct communities around Momostenango were surveyed and interviewed. A significant finding is that 85% of households were food insecure, with 93% relying on agriculture. Food-secure families mostly worked on their own or leased land, whereas food-insecure ones combined farming with day labor. In times of food scarcity, strategies such as altering food consumption and reducing expenses were common. Severely food-insecure families were significantly more likely to reduce portion sizes (72%), whereas food-secure families typically resorted to less preferred foods. Overall, food insecurity was notably linked to larger families, older mothers with limited education, and reliance on agricultural day labor. Food insecurity is a long-term issue in rural areas, deeply rooted in structural socioeconomic constraints, and recurring across generations.

The association of the quality of life with Afghan households' food insecurity before and after the recent political change in Afghanistan: a comparative analysis.

The overreaching objective of the current study is to investigate the association of quality of life with Afghan households' food insecurity. The data was collected immediately after the Taliban took control of a large part of Afghanistan. About a total of 555 households' heads participated in a face-to-face interview, using the HFIAS and WHOQOL-100 questionnaires along with some questions related to their socioeconomic characteristics at two different times, before and after the Taliban's takeover. The comparative analysis showed that 98% of Afghan households were food insecure after the Taliban takeover, while 70% of them faced food insecurity before the Taliban's takeover. The quality of life in the Taliban era is worse than before the Taliban. All dimensions of quality of life have decreased, and this decrease was more pronounced for the psychological, environmental, and physical domains. It is recommended that international organizations, NGOs, and local agents focus on these dimensions of the quality of life to improve food security.

Food Security Among Syrian Refugee Families in Quebec, Canada.

This study aims to understand how socioeconomic, geographic and cultural factors affect the food security status of Syrian refugee households in Quebec, Canada. Using a mixed methods study design, 49 households were assessed for their food security and socioeconomic status, followed by structured interviews with 35 households and 9 service providers. 52% of refugee households were food insecure, and although not significantly different, food insecurity was higher among privately sponsored refugee households in the Montreal area. Food insecurity appears mainly due to food access issues. Syrian refugees possess agricultural and cooking skills that could be beneficial in promoting community food security.

Dietary Patterns of Off-Reserve Indigenous Peoples in Canada and Their Association with Chronic Conditions.

Nationally representative nutrition surveys (Canadian Community Health Survey (CCHS) Cycle 2.2, Nutrition 2004 and 2015) were used to examine dietary patterns and their association with socioeconomic/sociodemographic factors and chronic conditions in off-reserve Indigenous population in Canada. A cluster analysis was used to identify dietary patterns (DPs), and the Nutrient Rich Food Index (NRF 9.3) was used as the diet quality score and stratified by age/gender groups. In 2004 (n = 1528), the dominant DPs among Indigenous adults (age = 41 ± 2.3) were "Mixed" (mean NRF = 450 ± 12) and "Unhealthy" among men (mean NRF = 426 ± 18), "Fruits" among women (mean NRF = 526 ± 29), and "High-Fat/High-Sugar" among children (age = 10.2 ± 0.5) (mean NRF = 457 ± 12). In 2015 (n = 950), the dominant DPs were "Unhealthy" (mean NRF = 466 ± 6), "Mixed" (mean NRF = 485 ± 21), Healthy-Like (mean NRF = 568 ± 37), and "Mixed" (mean NRF = 510 ± 9) among adults (age = 45.6 ± 2.2), men, women, and children (age = 10.9 ± 0.3) respectively. The majority of Indigenous peoples had the "Unhealthy" DP with a low diet quality, which may contribute to a high prevalence of obesity and chronic diseases. The income level and smoking status among adults and physical inactivity among children were recognized as important factors that may be associated with the dietary intake of off-reserve Indigenous population.

The assessment of an extended set of socio-economic determinants to explain anxiety and uncertainty, insufficient quality and food intake of Afghan refugees.

OBJECTIVES: In this study, socio-economic factors associated with Afghan refugee households' food insecurity, anxiety and uncertainty, insufficient quality and food intake were determined. DESIGN: Household Food Insecurity Assess Scale measurement was applied to assess food insecurity, anxiety and uncertainty, insufficient quality and insufficient food intake. Descriptive analysis and multivariable regression models were used to determine the associated factors. SETTING: The study was carried out in urban areas of Tehran province in Iran. PARTICIPANTS: To collect data, interviews were conducted among 317 Afghan households. The questionnaire was administered via face-to-face interviews to either the breadwinner of the selected households or a member who could respond on behalf of the household. RESULTS: About 11·3 % of Afghan households who resettled in Tehran province were food secure, while 11·7 % were marginally, 40·7 % moderately and 36·3 % severely food insecure. Economic and financial factors were inversely and significantly associated with food insecurity. Employment, income, distance from the central market and personal saving were inversely associated with food insecurity, while other determinants, including the length of living time in Tehran, house type and the number of male and female children, had a direct association with food insecurity. CONCLUSIONS: The associations of socio-economic factors with three categories of food insecurity differed. Elimination of occupation bans that the Iranian government imposes on refugees provides simple access to financial supports like long-term loans, and opening a bank account for refugees will benefit both Iranians and refugees.

Modeling the predictors of stunting in Ethiopia: analysis of 2016 Ethiopian demographic health survey data (EDHS).

BACKGROUND: Despite continued efforts to address malnutrition, there is minimal reduction in the prevalence rates of stunting in developing countries, including Ethiopia. The association between nutritional and socioeconomic factors collected from a national survey in Ethiopia and stunting have not been rigorously analyzed. Therefore, this study aims to model the effect of nutritional and socioeconomic predictors using 2016 Ethiopian Demographic Health Survey (EDHS) data. METHODS: This study is a secondary data analysis of the 2016 EDHS survey, which included 7909 children aged 6 to59 months. Descriptive statistics using frequency and percentage for categorical data and mean and standard deviation for metric data were conducted. Linearity, confounding, and multicollinearity were checked. Bivariable and multivariable logistic regression were carried out. The adjusted odds ratio (AOR) and 95% confidence interval (CI) were calculated. A receiver operative curve was built to estimate the sensitivity and specificity of the model. RESULTS: The study identified that 39.2% of children included in this analysis were stunted. Furthermore, 76.47, 84.27, and 92.62% of the children did not consume fruits and vegetables, legumes and lentils, or meat and its products, respectively. Children aged 24 months to 59 months were found to be at 9.71 times higher risk of being stunted compared to their younger counterparts aged 6-24 months (AOR: 9.71; CI: 8.07, 11.6 children). Those children weighing below 9.1 kg were at 27.86 odds of being stunted compared to those weighing 23.3 kg and above. Moreover, mothers with a height below 150 cm (AOR: 2.01; CI: 1.76, 2.5), living in a rural area (AOR: 1.3, CI: 1.09, 1.54), and being male (AOR: 1.4; CI: 1.26, 1.56) were factors associated with stunting. The predictive ability of the model was 77%: if a pair of observations with stunted and non-stunted children were taken, the model correctly ranks 77% of such pair of observations. CONCLUSION: The model indicates that being born male, being from a mother of short stature, living in rural areas, small child size, mother with mild anemia, father having no formal education or primary education only, having low child weight, and being 24-59 months of age increases the likelihood of stunting. On the other hand, being born of an overweight or obese mother decreases the likelihood of stunting.

Impact of Parent Engagement in Childhood Obesity Prevention Interventions on Anthropometric Indices among Preschool Children: A Systematic Review.

Background: Home environment, modeling of weight-related behaviors, and general parenting style are very important predictors of obesity in children. The effect of parent engagement in prevention of obesity in children is not clear. The main objective of this systematic review was to address the effects of parent engagement in obesity prevention interventions on anthropometric changes among preschool children. Methods: PubMed/Medline, Cochrane Library, ISI Web of Knowledge, Scopus, Science Direct, and Google Scholar were searched. Eligible studies were randomized controlled trials in last 10 years (from 2008 until February 14, 2018), which had a parent engagement in obesity prevention interventions (as an intervention) and children's anthropometric indices (as an outcome). Results: Twenty-six studies were included. Half of studies targeted both parents and children, and the rest targeted only parents. Types of interventions ranged from a simple motivational interviewing to professional skill training approaches. Studies that targeted overweight or obese children in their intervention containing training sessions followed by maintenance for parents and those that focused on individual support for overweight children and their parents, resulted in higher improvement in BMI and other outcomes. Conclusions: Anthropometric indices and BMI are not appropriate for reflecting the effectiveness of parent engagement in obesity prevention interventions. Having an individual component in the intervention and focusing more on parents vs. children in the intervention may result in improvement in anthropometric outcomes. Focusing on weight-related behaviors as the main outcome in both, children and parents, rather than anthropometric indices, is highly recommended for future reviews.

Consumption Patterns of Grain-Based Foods among Children and Adolescents in Canada: Evidence from Canadian Community Health Survey-Nutrition 2015.

The current analyses used data from the Canadian Community Health Survey-Nutrition 2015 to investigate grain-based food (GBF) dietary patterns of consumptions among 6,400,000 Canadian children and adolescents 2 to 18 years old. Nutrient intakes, socioeconomic differences, body mass index (BMI) z-scores, and intakes of several food groups were examined across the identified grain patterns of consumption. We employed k-mean cluster analysis to identify the consumption patterns of grain products. Based on the contributions of 21 grain food groups to the total energy intake of each individual, seven GBF consumption patterns were identified including other bread; salty snacks; pasta; rice; cakes and cookies; white bread; and mixed grains. Individuals having less than one serving of grain products were also separately categorized as no-grain consumers. Mean energy intake (kcal/day) was lowest for the "no-grain" consumers and greatest in children/adolescents consuming a "salty snacks" pattern when all GBF patterns were compared. Children and adolescents with "no-grain" and "rice" GBF consumption patterns had significantly lower intakes of several nutrients including dietary fiber, folate, magnesium, calcium, iron, zinc, thiamin, niacin, and riboflavin. No associations were observed with any of the identified GBF patterns and BMI z-scores. In addition, the socioeconomic status (SES) indicators such as household incomes and immigration status of participants were shown to be significantly different across the identified clusters.

Evidence for the Validity of the Children's Attraction to Physical Activity (CAPA) Scale in Iranian Preschool Children.

PURPOSE: The escalating trend of overweight and obesity is a major global health challenge and needs particular attention. There are a number of reasons for this increase, but the dominant one appears to be the pandemic of physical inactivity. It is now clear that children's attraction to physical activity is an important promising factor in children's physical activity involvement. In this study, we aimed to cross-validate the long version of children's attraction to physical activity (CAPA) scale in Iranian preschool children. DESIGN AND METHODS: Evidence for the validity of the scale was based on face validity, content validity, and internal consistency. The scale was translated into Persian and underwent forward translation, synthesis of the translation and backward translation. Face and content validity were subsequently assessed on individuals and expert panels. A sample of 30 preschool children (5-6 years of age) were randomly selected from three kindergartens. Children were interviewed by their kindergarten teachers. RESULTS: Internal consistency for each of the five subscales of the CAPA scale was evaluated through Cronbach's alpha. The internal consistency was acceptable for most of the subscales when negative statements were excluded from the analyses. CONCLUSIONS: The results supported the use of modified version of Persian-language long CAPA scale for Iranian preschool children, with the deletion of negatively worded items. PRACTICE IMPLICATIONS: Health care professionals may use the CAPA when assessing the attraction of children toward physical activity and its potential involvement in childhood obesity.

Chronic health disparities among refugee and immigrant children in Canada.

There are knowledge gaps in our understanding of the development of chronic disease risks in children, especially with regard to the risk differentials experienced by immigrants and refugees. The Healthy Immigrant Children study employed a mixed-methods cross-sectional study design to characterize the health and nutritional status of 300 immigrant and refugee children aged 3-13 years who had been in Canada for less than 5 years. Quantitative data regarding socioeconomic status, food security, physical activity, diet, and bone and body composition and anthropometric measurements were collected. Qualitative data regarding their experiences with accessing health care and their family lifestyle habits were gathered through in-depth interviews with the parents of newcomer children. Many newcomers spoke about their struggles to attain their desired standard of living. Regarding health outcomes, significantly more refugees (23%) had stunted growth when compared with immigrants (5%). Older children, those with better-educated parents, and those who consumed a poorer-quality diet were at a higher risk of being overweight or obese. Sixty percent of refugees and 42% of immigrants had high blood cholesterol. Significant health concerns for refugee children include stunting and high blood cholesterol levels, and emerging trends indicate that older immigrant children from privileged backgrounds in low-income countries may be more at risk of overweight and obesity. A variety of pathways related to their families' conceptualization of life in Canada and the social structures that limit progress to meeting their goals likely influence the development of health inequity among refugee and immigrant children. Public health initiatives should address these health inequities among newcomer families.

Promoting physical activity, healthy eating and gross motor skills development among preschoolers attending childcare centers: Process evaluation of the Healthy Start-Départ Santé intervention using the RE-AIM framework.

BACKGROUND: The Healthy Start-Départ Santé intervention was developed to promote physical activity, gross motor skills and healthy eating among preschoolers attending childcare centers. This process evaluation aimed to report the reach, effectiveness, adoption, implementation and maintenance of the Healthy Start-Départ Santé intervention. METHODS: The RE-AIM framework was used to guide this process evaluation. Data were collected across 140 childcare centers who received the Healthy Start-Départ Santé intervention in the provinces of Saskatchewan and New Brunswick, Canada. Quantitative data were collected through director questionnaires at 10 months and 2 years after the initial training and analyzed using descriptive statistics. Qualitative data were collected throughout the intervention. RESULTS: The intervention was successful in reaching a large number of childcare centres and engaging both rural and urban communities across Saskatchewan and New Brunswick. Centres reported increasing opportunities for physical activity and healthy eating, which were generally low-cost, easy and quick to implement. However, these changes were rarely transformed into formal written policies. A total of 87% of centers reported using the physical activity resource and 68% using the nutrition resource on a weekly basis. Implementation fidelity of the initial training was high. Of those centers who received the initial training, 75% participated in the mid-point booster session training. Two year post-implementation questionnaires indicated that 47% of centers were still using the Active Play Equipment kit, while 42% were still using the physical activity resource and 37% were still using the nutrition resource. Key challenges to implementation and sustainability identified during the evaluation were consistent among all of the REAIM elements. These challenges included lack of time, lack of support from childcare staff and low parental engagement. CONCLUSIONS: Findings from this study suggest the implementation of Healthy Start-Départ Santé may be improved further by addressing resistance to change and varied levels of engagement among childcare staff. In addition, further work is needed to provide parents with opportunities to engage in HSDS with their children.

The Good Food Junction: a Community-Based Food Store Intervention to Address Nutritional Health Inequities.

BACKGROUND: This is a 2-year study to assess the early impacts of a new grocery store intervention in a former food desert. OBJECTIVE: The purpose of the study is to understand the early health effects of the introduction of a large-scale food and nutrition-focused community-based population health intervention, the Good Food Junction (GFJ) Cooperative Store, in a geographically bounded group of socially disadvantaged neighborhoods (the "core neighborhoods") in a midsized Canadian city. The GFJ grocery store was tasked with improving the access of residents to healthy, affordable food. The 5 research questions are: (1) What is the awareness and perception of the GFJ store among residents of the core neighborhoods? (2) Are there differences in awareness and perception among those who do and do not shop at the GFJ? (3) Will healthy food purchasing at the GFJ by residents of the core neighborhoods change over time, and what purchases are these individuals making at this store? (4) What early impact(s) will the GFJ have on key health-related outcomes (such as household food security status, vegetable and fruit intake, key aspects of self-reported mental health, self-reported health)? and (5) Are the effects of the intervention seen for specific vulnerable population groups, such as Aboriginal people, seniors (65 years old or older) and new immigrants (settled in Saskatoon for less than 5 years)? METHODS: The research project examined initial impacts of the GFJ on the health of the residents in surrounding neighborhoods through a door-to-door cross-sectional survey of food access and household demographics; an examination of GFJ sales data by location of shoppers' residences; and a 1-year, 3-time-point longitudinal study of self-reported health of GFJ shoppers. RESULTS: Analyses are on-going, but preliminary results show that shoppers are using the store for its intended purpose, which is to improve access to healthy food in a former food desert. CONCLUSIONS: To our knowledge this is the first large-scale study of a full-service grocery store intervention in a former food desert in Canada that has used multiple data sources, as well as longitudinal analyses, to examine its effects. Its findings will contribute significantly to the knowledge base on food environment interventions.