Assessing and Monitoring Nutrition Security to Promote Healthy Dietary Intake and Outcomes in the United States.

The US Department of Agriculture's Economic Research Service leads the federal government in data development and research on food security in US households. Nutrition security is an emerging concept that, although closely related, is distinct from food security. No standard conceptualization or measure of nutrition security currently exists. We review the existing research on nutrition security and how it is informed by the more robust literature on food security and diet quality. Based on this review, we propose a conceptual framework for understanding nutrition security and its relationship to food security. We identify two constructs (healthy diets and nutritional status) and multiple subconstructs that form the basis of nutrition security. The proposed framework and corresponding constructs are intended to provide (a) understanding of how nutrition security arises and how it differs from food security, (b) background on why assessment and monitoring of nutrition security is important, and (c) guidance for a research agenda that will further clarify the meaning of nutrition security and its measurement.

A theoretical explanation for how a nutrition counseling and medically tailored meal delivery program benefitted participants living with lung cancer.

PURPOSE: The purpose of this study was to assess participants' perceptions and experiences while participating in a Food is Medicine medically tailored meal plus intensive nutrition counseling intervention to create a theoretical explanation about how the intervention worked. METHODS: This interpretive qualitative study included the use of semi-structured interviews with active participants in a randomized controlled trial aimed at understanding how a medically tailored meal plus nutrition counseling intervention worked for vulnerable individuals with lung cancer treated at four cancer centers across the USA. During the 8-month long study, participants in the intervention arm were asked to be interviewed, which were recorded, transcribed verbatim, and analyzed using conventional content analysis with principles of grounded theory. RESULTS: Twenty individuals participated. Data analysis resulted in a theoretical explanation of the intervention's mechanism of action. The explanatory process includes three linked and propositional categories leading to patient resilience: engaging in treatment, adjusting to diagnosis, and active coping. The medically tailored meals plus nutrition counseling engaged participants throughout treatment, which helped participants adjust to their diagnosis, leading to active coping through intentional self-care, behavior change, and improved quality of life. CONCLUSIONS: These findings provide evidence that a Food is Medicine intervention may buffer some of the adversity related to the diagnosis of lung cancer and create a pathway for participants to experience post-traumatic growth, develop resilience, and change behaviors to actively cope with lung cancer. Medically tailored meals plus intensive nutrition counseling informed by motivational interviewing supported individuals' adjustment to their diagnosis and resulted in perceived positive behavior change.

Association between participation in the supplemental nutrition assistance program and perception of limited availability and choice of healthy foods.

BACKGROUND: Nutrition security encompasses stable and equitable access, availability, affordability, and utilization of healthy foods. AIM: To evaluate the relationship of two newly created dichotomous measures that represent aspects of nutrition security (i.e., perceived limited availability and healthfulness choice) with Supplemental Nutrition Assistance Program (SNAP) participation. METHODS: Logistic regression models were run for each outcome separately with adjustment for age, income-to-poverty ratio, gender, education, race, and food security. RESULTS: Adults using social services (e.g., food pantries) were enrolled (N = 402) in this cross-sectional analysis. SNAP participants (61.7%) were not different from non-SNAP participants in perceiving limited availability (aOR [95% CI]: 1.21 [0.75, 1.95]) or limited ability to choose (aOR [95% CI]: 0.69 [0.43, 1.12]) healthy foods. CONCLUSIONS: Both SNAP and non-SNAP participants with low socioeconomic status report limited availability of healthy foods in their environment and a limited ability to choose healthy foods.

Aiming at low nitrogen leaching diets based on nitrogen fertilizer regulatory policy: A regional bio-economic assessment of the Zayandeh-Rud river basin-Iran.

Negative environmental impacts of nitrogen (N) intensive diets have triggered global debates on sustainable nitrogen management. Solutions such as dietary transitions, cropland reallocation and N Regulatory Policy (NRP) have been proposed to mitigate the adverse environmental impacts of N use in food production. However, there is still insufficient understanding of how NRPs could be designed to minimize negative environmental impact across diverse agro-ecological zones without sacrificing human dietary requirements. To increase this understanding, we evaluated the consequences of three NRP scenarios (low, moderate, and high N fertilizer rates) on the amount of livestock and non-livestock diet components as well as the associated N leaching and farmers' Gross Margin (GM) by optimizing the allocation of cropland between food and feed crops. We developed a bio-economic Interval Fuzzy Multi-Objective Programming (bio-economic IFMOP) model for the Zayandeh-Rud river basin, Iran, and a procedure that accounts for annual average availability of calories per capita, calorie sources from livestock and non-livestock components of three dietary preferences, and inequality in calorie distribution. The interaction among soil, climate and weather variability and NRPs across nine sub-regions of the case study region was handled by crop yield simulation using the DSSAT software. The solution of farmers' GM, derived from the optimization problem across possibilities of water fluctuations, was assessed to determine the uncertainty in GM. We also introduced an N leaching per Block of Distributed Calories (BDC) criterion based on solutions of supplied calories and associated N leaching. The upper bound of the moderate NRP scenario resulted in the smallest N leaching per BDC. This corresponded to ∼0.34, ∼0.34, ∼3.77 and 19.00 million BDC of meat, dairy, wheat and potato, respectively. Also, the upper bound of this scenario satisfied the lowest instability in farmers' GM against water fluctuation compared with low and high NRP scenarios. The affordable volume of N leaching per BDC varied across sub-regions between [1.53,3.49], [1.52,3.33], [0.76,0.99] and [0.05,0.08] kg for meat, dairy, wheat and potato, respectively. Our results highlighted both optimistic and pessimistic prospects of producing low N leaching diets. The approach of this study could also be applied to other regions and countries.

An Exploratory Study of the Perceived Need for and Acceptability of a Healthy Frozen Meal Product Among Rural Corner Store Customers in North Carolina.

This pilot study assesses barriers to obtaining healthy affordable food and the early-stage acceptability of a novel subsidized healthy frozen meal product designed to address food insecurity and nutritional status among corner store customers in rural North Carolina. A convenience sample of 50 customers were surveyed to examine the perceived availability of healthy food options, barriers to maintaining healthy diets, food shopping and consumption habits, and reception of the product. Findings confirmed barriers to obtaining healthy foods that the product seeks to address, the validity of corner stores as the intervention site, and approval of the product's taste and concept.

Importance of Nutrition Security to CVD Prevention Efforts in the USA.

PURPOSE OF REVIEW: The importance of addressing nutrition security for the primary and secondary prevention of cardiovascular disease (CVD) in the USA is reviewed by describing the relationships between food security, diet quality, and CVD risk along with the ability of governmental, community, and healthcare policies and interventions to address nutrition security. RECENT FINDINGS: Existing safety net programs have shown to be effective at improving food security and diet quality and reducing risk for CVD, but continued efforts to increase reach and improve standards are needed. Adoption of policies, healthcare initiatives, and community- and individual-level interventions addressing the nutritional intake of socioeconomically disadvantaged populations may also lessen CVD burden, but scaling interventions remains a key challenge. Research suggests simultaneously addressing food security and diet quality is feasible and could help reduce socioeconomic disparities in CVD morbidity and mortality. Intervening at multiple levels among high-risk groups should be a priority.

Food Insecurity and Chronic Kidney Disease: Considerations for Practitioners.

The coronavirus disease 2019 pandemic has exacerbated existing health disparities related to food security status. Emerging literature suggests individuals with Chronic Kidney Disease (CKD) who are also food insecure have a greater likelihood of disease progression compared to food secure individuals. However, the complex relationship between CKD and food insecurity (FI) is understudied relative to other chronic conditions. The purpose of this practical application article is to summarize the recent literature on the social-economic, nutritional, to care through which FI may negatively impact health outcomes in individuals with CKD. While several studies have reported on the cross-sectional prevalence of FI among persons with CKD, literature is lacking about the severity and duration of exposure to FI on CKD outcomes. Future research is needed to better understand how FI impairs CKD care, nutritional and structural barriers that impact disease prevention and disease progression, and effective strategies to support patients.

The Implementation of a Nutrition Intervention in Food Pantries: The Spirit of SWAP.

Background. Food insecurity, affecting approximately 10% of the U.S. population, with up to 40% or higher in some communities, is associated with higher rates of chronic conditions and inversely associated with diet quality. Nutrition interventions implemented at food pantries are an effective strategy to increase healthy food choices and improve health outcomes for people experiencing food and nutrition insecurity. Supporting Wellness at Pantries (SWAP), a stoplight nutrition ranking system, can facilitate healthy food procurement and distribution at pantries. Purpose. Guided by the RE-AIM Framework, this study assesses the implementation and outcomes of SWAP as nutritional guidance and institutional policy intervention, to increase procurement and distribution of healthy foods in pantries. Method. Mixed-methods evaluation included observations, process forms, and in-depth interviews. Food inventory assessments were conducted at baseline and 2-year follow-up. Results. Two large pantries in New Haven, Connecticut, collectively reaching more than 12,200 individuals yearly, implemented SWAP in 2019. Implementation was consistent prepandemic at both pantries. Due to COVID-mandated distribution changes, pantries adapted SWAP implementation during the pandemic while still maintaining the "spirit of SWAP." One pantry increased the percentage of Green foods offered. Challenges to healthy food distribution are considered. Discussion. This study has implications for policy, systems, and environmental changes. It shows the potential for SWAP adoption at pantries, which can serve as a guide for continued healthy food procurement and advocacy. Maintaining the "spirit of SWAP" shows promising results for food pantries looking to implement nutrition interventions when standard practice may not be possible.

Changes in China's food security driven by nutrition security and resource constraints.

Food security and the utilization of natural resources in a sustainable manner are vital to the expansion of China's agricultural system. The relationship between environmental pressure and dietary structure has influenced the quantity and spatial distribution of China's food supply and demand, but it has not been evaluated. Our research centered on the security of China's food nutrition-resources-food (NRF) system, considering the inherent relationship between food security, nutritional health, and resource security. The following are the study's findings: (1) The Chinese population is rapidly changing from a diet focused on grains to a more diverse diet. Between 1990 and 2019, the dietary quality and nutritional status of Chinese individuals have vastly improved. In terms of nutrient levels, discrepancies between urban and rural resident persist, with urban residents consuming a diet that is closer to the ideal structure. However, the structure of rural residents' food consumption is diversifying, and the gap between urban and rural residents is gradually narrowing. (2) From 2000 to 2019, the pressure, status, and response indices of China's NRF system all show an upward trend, and the security of the NRF system has steadily grown. The magnitude of change in the response index exceeded that of the state index, which exceeded that of the pressure index. This indicates that the increase in the pressure and state indices of the NRF system was primarily attributable to the effectiveness of policy efforts.

Food and Nutrition Security Among Households With Children in North Carolina: Challenges, Opportunities, and Potential Policy Solutions.

In North Carolina, childhood food and nutrition insecurity are persistent problems. This article explores challenges, highlights potential opportunities, and proposes policy solutions for food and nutrition insecurity among households with children. North Carolina is poised to ensure adequate, healthy, affordable, and accessible nutrition for its youngest residents.

The "Nutritional Prevention" within Italy's National Prevention Plan 2020-25.

Abstract: Italy's National Prevention Plan 2020-25 is the first to address nutritional prevention, highlighting its importance in combating chronic diseases. This letter discusses the relationship between food safety, nutritional security, and the need for nutritional prevention in the plan. Chronic diseases, such as cardiovascular disease, cancer, and diabetes, are significant public health concerns in Italy, with poor nutrition being a critical risk factor. Incorporating nutritional prevention can promote healthy eating habits, food security and sustainability, reduce healthcare costs, and promote social cohesion and equality. Successful implementation will require cooperation among the government, the private sector, and the civil society to ensure healthier food choices and prevent chronic diseases in Italy.

Animal by-products collagen and derived peptide, as important components of innovative sustainable food systems-a comprehensive review.

In 2020, the world's food crisis and health industry ushered into a real outbreak. On one side, there were natural disasters such as the novel coronavirus (2019-nCoV), desert locusts, floods, and droughts exacerbating the world food crisis, while on the other side, the social development and changes in lifestyles prompted the health industry to gradually shift from a traditional medical model to a new pattern of prevention, treatment, and nourishment. Therefore, this article reviews animal by-products collagen and derived peptide, as important components of innovative sustainable food systems. The review also considered the preparation, identification, and characterization of animal by-product collagen and collagen peptides as well as their impacts on the food system (including food processing, packaging, preservation, and functional foods). Finally, the application and research progress of animal by-product collagen and peptide in the food system along with the future development trend were discussed. This knowledge would be of great significance for a comprehensive understanding of animal by-product collagen and collagen peptides and would encourage the use of collagen in food processing, preservation, and functional foods.

Development of new measures to assess household nutrition security, and choice in dietary characteristics.

The purpose of this study was to preliminarily develop novel self-administered measures to assess nutrition security and choice in dietary characteristics. Measures were piloted in a convenience sample of households at risk for food insecurity in the United States. The survey included the new measures, construct validation variables (household food security, self-reported general health, and dietary variables), and demographic questions. Exploratory factor analysis was used to assess dimensionality, internal (Cronbach's alpha (CA)), and construct validity were assessed (Spearman's correlation). Multivariate logistic regression models were used to assess added utility of the new measures beyond food security measurement. Finally, brief screener versions of the full measures were created. Participants in the analytic sample (n = 380) averaged 45 years old, 71% experiencing food insecurity, 42% with high school diploma or less, 78% were women, and racially/ethnically diverse. Scores for the Household Nutrition Security (CA = 0.85; Mean = 2.58 (SD = 0.87)), Household Healthfulness Choice (CA = 0.79; Mean = 2.47 (SD = 0.96)), and Household Dietary Choice (CA = 0.80; Mean = 2.57 (SD = 0.90)) were positively associated with food security (0.401-0.657), general health (0.194-0.290), fruit and vegetable intake frequency (0.240-0.280), and "scratch-cooked" meal intake (0.328-0.350), and negatively associated with "processed" meal intake (-0.162 to -0.234) and an external locus of nutrition control (-0.343 to -0.366). Further, findings show that the new measures are useful for assessing risk for poor dietary and health outcomes even after controlling for household food security status and sample characteristics. These findings are encouraging and support reliability, construct validity, and utility of these new measures. Following further testing, such as Confirmatory Factor Analysis in future samples, these measures may be used in various applications to contribute to a better understanding of households' limitations for accessing healthful foods and foods that meet their preferences.

Safety, regulatory and environmental issues related to breeding and international trade of edible insects in Africa.

Insect breeding or farming for food and feed is an emerging enterprise that can address the ever-growing demand for protein and curb high unemployment rates in Africa and beyond. However, for the sector to prosper, its value chain needs to be regulated to ensure sustainability and safety for consumers and the environment. Although a few African countries, such as Kenya, Uganda and Rwanda, have promulgated standards on the use of insects as food and feed, greater efforts are needed in other countries, and relevant policies governing the sector need to be formulated. All over the globe, attention to the regulation of the edible insect sector is increasing, and more investment in the industry is foreseen. Safety issues such as identifying which species should be reared, substrate quality and traceability imposed by importing countries will be critical for expansion of the sector. This paper analyses safety, regulatory and environmental issues related to breeding and international trade of edible insects in Africa and provides case studies and recommendations for sustainable use of insects for food and feed.

Les élevages et les fermes d'insectes destinés à l'alimentation humaine et animale sont de nouvelles entreprises qui pourraient répondre à la hausse continue de la demande en protéines tout en réduisant les taux élevés du chômage en Afrique et ailleurs. Néanmoins, pour que ce secteur puisse prospérer, sa chaîne de création de valeur doit être réglementée afin de garantir sa durabilité et son innocuité pour les consommateurs et l'environnement. Si un petit nombre de pays africains dont le Kenya, l'Ouganda et le Rwanda ont élaboré des normes applicables à l'utilisation des insectes pour l'alimentation humaine et animale, dans d'autres pays les efforts doivent se poursuivre et des politiques appropriées doivent être mises en place pour régir ce secteur. Partout dans le monde, la réglementation du secteur des insectes comestibles fait désormais l'objet d'une attention considérable et des investissements accrus dans la filière sont attendus. Les questions de sécurité telles que l'identification des insectes à élever, la qualité du substrat et la traçabilité exigée par les pays importateurs seront cruciales pour le développement du secteur. Les auteurs analysent les questions de sécurité et les enjeux réglementaires et environnementaux liés à l'élevage et au commerce international d'insectes comestibles en Afrique et présentent des études de cas et des recommandations pour une utilisation durable des insectes destinés à l'alimentation humaine et animale.

La cría o producción de insectos con fines de alimentación humana o animal es una actividad incipiente que puede ayudar a responder a la siempre creciente demanda de proteínas y a contener las elevadas tasas de desempleo de África y otras regiones. Para que el sector prospere, no obstante, es preciso reglamentar su cadena de valor a fin de asegurar su sostenibilidad y su inocuidad para el consumidor y el medio ambiente. Aunque unos pocos países africanos, como Kenia, Uganda o Ruanda, tienen promulgadas normas sobre el uso de insectos para la alimentación humana o la producción de piensos, aún hay que redoblar esfuerzos en otros países y formular políticas que ordenen el sector. En todo el planeta se presta hoy una atención sin precedentes a la regulación del sector de los insectos comestibles, un sector que previsiblemente va a recibir cada vez más inversiones. Las cuestiones ligadas a la inocuidad, como la identidad de los insectos que se van a producir, la calidad del substrato o la rastreabilidad impuesta por los países importadores, serán fundamentales para el desarrollo del sector. Los autores analizan las cuestiones reglamentarias, ambientales y de inocuidad que se plantean en relación con la cría y el comercio internacional de insectos comestibles en África, presentan ejemplos concretos y formulan recomendaciones para un uso sostenible de los insectos con fines de alimentación humana o animal.

Interventions and policies aimed at improving nutrition in Small Island Developing States: a rapid review.

Objective: To describe features of nutritional interventions implemented in Small Island Developing States (SIDS) in the past 20 years. Methods: A rapid scoping review was conducted by searching PubMed and Web of Science databases for interventions conducted in SIDS that sought to improve the nutrition of their populations between 2000 and 2019 inclusive. The Noncommunicable diseases progress monitor 2020 was also examined to assess nutritional policies in SIDS. Results: A total of 174 interventions were implemented in 49 of the 58 SIDS. The greatest proportion were conducted in the Caribbean (75 interventions; 43%), with the Pacific region, and the Atlantic, Indian Ocean, Mediterranean and South China Sea region each implementing about 30% of interventions. Using the NOURISHING framework, most interventions (67%) were implemented at the community and national or policy level, using multiple components of the framework. The greatest proportion of interventions (35%) were educational and awareness raising. Restrictions on physical availability of and increased taxation on alcohol were the most commonly reported policies that were partially or fully achieved; restrictions on fats were the least commonly reported. These findings were generally consistent across the SIDS regions. Conclusions: There is a paucity of nutritional policies in SIDS; the reasons may be linked to their social, economic, and environmental vulnerabilities. Interventions should be expanded beyond education to encompass multiple components of the NOURISHING framework, with multisectoral inclusion to ensure stronger stakeholder collaboration and buy-in. A systematic review is warranted using a fuller range of sources to assess the effectiveness of interventions.

Improving household nutrition security and public health in the CARICOM, 2018-2022.

The Caribbean is experiencing a worsening epidemic of obesity and noncommunicable diseases (NCDs) and it has the worst rates of premature mortality from cardiovascular diseases in the region of the Americas. Creating enabling environments to improve dietary diversity would help reduce obesity and diet-related NCDs. The Improving Household Nutrition Security and Public Health in the CARICOM project aimed to increase dietary diversity in the Caribbean, and to determine and implement effective, gender-sensitive interventions to improve food sovereignty, household food security, and nutrition in CARICOM states. Primary quantitative and qualitative research, scoping reviews, stakeholder engagement, implementation of interventions and dissemination activities were undertaken. This paper describes the overall project design and implementation, discusses challenges and limitations, and presents core achievements to inform further work in Small Island Developing States throughout CARICOM to advance the nutrition agenda in the Caribbean. The results of the project's research activities are presented in other papers published in this special issue on nutrition security in CARICOM states.

El Caribe está registrando un empeoramiento de la epidemia de obesidad y enfermedades no transmisibles (ENT) y presenta las peores tasas de mortalidad prematura por enfermedades cardiovasculares de la Región de las Américas. La creación de entornos propicios para mejorar la diversidad alimentaria contribuiría a reducir la obesidad y las ENT relacionadas con la alimentación. El proyecto "Mejorar la seguridad nutricional de los hogares y la salud pública en CARICOM" tiene por objetivo ampliar la diversidad alimentaria en el Caribe y acordar y ejecutar intervenciones efectivas con perspectiva de género para mejorar la soberanía alimentaria, la seguridad alimentaria de los hogares y la nutrición en los Estados de CARICOM. Se llevaron a cabo investigaciones primarias cuantitativas y cualitativas, revisiones exploratorias, ejecución de intervenciones y actividades de difusión, y se impulsó la participación de las partes interesadas. En este artículo se describen el diseño y la ejecución del proyecto en general, se analizan sus desafíos y limitaciones, y se presentan sus logros básicos para que se tengan en cuenta en la labor adicional que realizan los pequeños Estados insulares en desarrollo de CARICOM con el fin de impulsar la agenda de nutrición en el Caribe. Los resultados de las actividades de investigación del proyecto se presentan en otros documentos publicados en este número especial sobre seguridad nutricional en los Estados de CARICOM.

O Caribe está passando por um agravamento da epidemia de obesidade e doenças não transmissíveis (DNTs) e tem as piores taxas de mortalidade prematura por doenças cardiovasculares na Região das Américas. A criação de ambientes favoráveis para melhorar a diversidade alimentar ajudaria a reduzir a obesidade e as DNTs relacionadas à alimentação. O projeto Improving Household Nutrition Security and Public Health in the CARICOM [Melhoria da segurança nutricional doméstica e da saúde pública na CARICOM] teve como objetivo aumentar a diversidade alimentar no Caribe e determinar e implementar intervenções eficazes e sensíveis ao gênero para melhorar a soberania alimentar, a segurança alimentar doméstica e a nutrição nos estados da CARICOM. Foram realizadas pesquisas quantitativas e qualitativas primárias, revisões de escopo, ações de envolvimento das partes interessadas, implementação de intervenções e atividades de divulgação. Este documento descreve a elaboração e a implementação geral do projeto, analisa seus desafios e limitações e apresenta as principais realizações para informar o trabalho futuro nos pequenos Estados insulares em desenvolvimento em toda a CARICOM, visando a avançar a agenda nutricional no Caribe. Os resultados das atividades de pesquisa do projeto são apresentados em outros artigos publicados neste número especial sobre segurança nutricional nos Estados da CARICOM.

Food Insecurity and Diabetes: An Investigation of Underserved Asian Americans in Michigan.

Asian Americans are at increased risk for nutrition-related chronic diseases, including type 2 diabetes. The prevalence of type 2 diabetes among Asian Americans in the United States is 16.7% compared to 11.3% among the general U.S. population. Genetic factors such as higher body fat and lower muscle mass result in a predisposition for the development of diabetes at a lower body mass index (BMI). Social determinants including food insecurity and physical environment may also impact risk and need further examination. This study investigated type 2 diabetes-related indicators and food insecurity and satisfaction with types and quality of foods provided through food box distributions with a focus on Asian American populations in Michigan. Data were collected via a survey implemented in partnership with community organizations that administer food box distributions. Nearly half of respondents were not aware that Asian Americans are at increased risk of developing type 2 diabetes. The mean BMI for overall study participants was 25.6, and 61.8% of participants had a BMI of ≥23. Food insecurity was also negatively associated with BMI with study participants who were overweight reporting less food insecurity. Overall, participants reported being satisfied with both the types and quality of foods provided in the food boxes. Findings support the need for increased diabetes education and testing among Asian Americans and assessment of the types of culturally relevant foods offered by food distribution organizations.

Crop diversification and farm household food and nutrition security in Northern Ghana.

Farm households in Africa adopt resource allocation tools such as crop diversification to minimize risk exposure and safeguard their food and nutrition security. This study uses primary data and an ordered probit model to examine how crop diversification impacts the food security outcomes of rural farmers in northern Ghana. The findings revealed that along with other factors like access to extension services and use of soil fertility management practices, crop diversification increased food access and reduced the food insecurity experience of households. As a result, policies targeted at improving the food and nutrition security of peasant households should promote adoption of diversified crop production and use of sustainable soil management practices like composting.

Household food insecurity and dietary diversity of women of reproductive age among smallholder farming households in northwest Bangladesh.

Despite Bangladesh's remarkable progress in agricultural production over the past few decades, household food and nutrition insecurity persist, especially in rural areas. The nutrition security and dietary diversity are even more critical for women of reproductive age among smallholders. This study examined household food insecurity and dietary diversity of women of reproductive age in the rural areas of northwest Bangladesh. Using cross-sectional data collected from 252 smallholder households, we measured household food insecurity and dietary diversity of women of reproductive age by the Household Food Insecurity Access Scale and the Minimum Dietary Diversity for Women, respectively. Determinants of household food insecurity were examined, and associations between household food insecurity and low dietary diversity were determined. The majority of the households were mildly insecure (51.2%) followed by moderately insecure (27.4%). The households felt anxiety of food insecurity for more than six months a year (Food Security Index = 2.10 out of 4.00). The mean food group consumed by women was 4.63 indicating low dietary diversity and dominance of diets by grains and dark green leafy vegetables. The findings also indicate a significant and positive association between household food insecurity and low dietary diversity of women. Education of household heads, household size, access to information sources, access to credit support, and perceived impacts of climate change on crop production were identified as determinants of household food insecurity. The study recommends that appropriate interventions be formulated to improve the food and nutrition security in the study areas.

Community-based approach to combat micronutrient deficiencies among irular tribal women: An education intervention.

Tribal women may suffer from poor nutritional health, lack of awareness of micronutrients, reduced dietary diversity, underutilization of micronutrient supplements and locally available food resources, poor hygiene, and sanitation. This study aims to examine the impact of educational intervention on the micronutrient status of the tribal women (n = 714, 15-60 years) in 15 hamlets of Coimbatore district, Tamil Nadu, by census sampling method. Self-structured pretested questionnaires, participatory learning methods, and focus group discussions were adopted to record the background information (anthropometry, clinical signs of micronutrient deficiency, hemoglobin, and dietary assessments). Even though there was no increase in body mass index (BMI), there was a significant change in age, income, and BMI with hemoglobin levels. Impact analysis showed significant behavior change in the utilization of locally available micronutrient-rich foods, improved access to supplements, and dietary diversity. Sustained attempts to educate tribal women proved to be effective in attaining their nutritional security and in the families.