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2.
J Dent Hyg ; 93(6): 42-50, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31882560

RESUMO

Purpose. To determine the association of eating competence and Mediterranean diet adherence with oral health and to examine if they lessen any impact of food insecurity on oral health of SNAP-eligible persons.Methods. Free clinic patrons (n=93) in Pennsylvania evaluated oral health nutrition education via an online survey. The Satter Eating Competence Inventory, Mediterranean diet and USDA Food Security scores were compared to tested measures of oral health as assessed by self-report.Results. Respondents noted food insecurity (33%), food selection (32%), and oral health problems that interfered with life satisfaction (30%), and unafforded dental care (60%). Mediterranean diet adherence was associated with annual dental visits (82% vs. 46%, p=.026). Competent eaters had greater food security and less frequently reported oral health issues interfering with life satisfaction (13% vs. 43%; p=.002) or avoiding particular foods (18% vs 45%; p=.006). These relationships remained significant controlling for low-income (p=.008, p=.006 respectively) but not when controlling for food security.Conclusions. Competent eaters had fewer oral health issues except when controlling for food security, a considerable challenge to oral health.


Assuntos
Assistência Alimentar , Estudos Transversais , Dieta , Alimentos , Abastecimento de Alimentos , Humanos , Saúde Bucal , Pobreza
3.
MMWR Morb Mortal Wkly Rep ; 68(46): 1057-1061, 2019 Nov 22.
Artigo em Inglês | MEDLINE | ID: mdl-31751324

RESUMO

Obesity negatively affects children's health because of its associations with cardiovascular disease risk factors, type 2 diabetes, asthma, fatty liver disease, victimization stemming from social stigma and bullying, and poor mental health (e.g., anxiety and depression) (1). Children who have overweight or obesity in early childhood are approximately four times as likely to have overweight or obesity in young adulthood as their normal weight peers (2). Obesity prevalence is especially high among children from low-income families (3). In 2010, the overall upward trend in obesity prevalence turned downward among children aged 2-4 years enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), a program of the U.S. Department of Agriculture (USDA); prevalence decreased significantly in all racial/ethnic groups and in 34 of the 56 WIC state or territory agencies during 2010-2014 (4). A more recent study among young children enrolled in WIC reported that the overall obesity prevalence decreased from 15.9% in 2010 to 13.9% in 2016 and statistically significant decreases were observed in all age, sex, and racial/ethnic subgroups (3). However, this study did not provide obesity trends at the state level. In collaboration with USDA, CDC used data from the WIC Participant and Program Characteristics (WIC PC) to update state-specific trends through 2016. During 2010-2016, modest but statistically significant decreases in obesity prevalence among children aged 2-4 years enrolled in WIC occurred in 41 (73%) of 56 WIC state or territory agencies. Comprehensive approaches that create positive changes to promote healthy eating and physical activity for young children from all income levels,* strengthen nutrition education and breastfeeding support among young children enrolled in WIC, and encourage redemptions of healthy foods in WIC food packages could help maintain or accelerate these declining trends.


Assuntos
Assistência Alimentar/estatística & dados numéricos , Obesidade Pediátrica/epidemiologia , Pré-Escolar , Feminino , Humanos , Masculino , Prevalência , Estados Unidos/epidemiologia
4.
BMC Public Health ; 19(1): 1419, 2019 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-31666032

RESUMO

BACKGROUND: Childhood stunting is the most common manifestation of chronic malnutrition. A growing body of literature indicates that stunting can have negative repercussions on physical and cognitive development. There are increasing concerns that low- and middle-income countries (LMICs) are particularly susceptible to adverse consequences of stunting on economic development. The aim of this review is to synthesize current evidence on interventions and policies that have had success in reducing stunting and explore the impact of successes on economic indicators. METHODS: This review adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Articles were searched through MEDLINE via PubMed and Ovid, Cochrane Library, Web of Science and ProQuest. Only articles that addressed the effects of nutrition and cash-based interventions and/or policies on stunting and reported effects on childhood mortality and/or human capital indicators were included. Two reviewers independently abstracted data and assessed quality. RESULTS: Seventeen studies from Africa (47%), South America (41%), and South Asia (12%) met the eligibility criteria: 8 cohort studies, 4 case studies, 4 Randomized Control Trials (RCTs) and 1 quasi-trial. Three types of interventions/policies were evaluated: multisectoral policies, nutritional supplementations and cash-based interventions (CCT). Overall, 76% of the included studies were successful in reducing stunting and 65% of interventions/policies reported successes on stunting reductions and economic successes. Five of the 11 successful studies reported on nutritional supplementation, 4 reported on multisectoral policies, and 2 reported on CCT interventions. Average Annual Rate of Reduction (AARR) was calculated to assess the impact of multisectoral policies on childhood mortality. AARR for under 5 mortality ranged from 5.2 to 6.2% and all countries aligned with the global target of 4.4% AARR. Quality assessment yielded positive results, with the biggest concerns being attrition bias for cohort studies, blinding for trials and generalizability of results for case studies. CONCLUSIONS: Evidence suggests that investment in fighting chronic malnutrition through multisectoral policies, multi-year nutritional supplementation (protein or multiple micronutrient supplementation) and possibly CCTs can have a long-term impact on economic development of LMICs. More evidence is needed to inform practices in non-represented regions while prioritizing standardization of economic indicators in the literature.


Assuntos
Países em Desenvolvimento , Desenvolvimento Econômico , Assistência Alimentar/economia , Transtornos do Crescimento/prevenção & controle , Desnutrição , Estado Nutricional , Políticas , África , Ásia , Criança , Países em Desenvolvimento/economia , Dieta , Suplementos Nutricionais , Transtornos do Crescimento/economia , Transtornos do Crescimento/etiologia , Humanos , Desnutrição/complicações , Desnutrição/dietoterapia , Desnutrição/economia , Pobreza , América do Sul
5.
Matern Child Health J ; 23(12): 1648-1657, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31535257

RESUMO

OBJECTIVES: Intimate partner violence (IPV) around the time of pregnancy is a risk factor for adverse pregnancy and birth outcomes. The supplemental nutrition program for women, infants, and children (WIC), available to low income pregnant women, may provide an opportunity to identify victims of IPV and refer them to services. This cross-sectional study aims to determine whether WIC participants are more likely than non-WIC participants to have reported IPV before or during pregnancy in the United States. METHODS: The 2004-2011 National Pregnancy Risk Assessment Monitoring System (PRAMS) survey (n = 319,689) was analyzed in 2015. Self-reported WIC participation, pre-pregnancy IPV, and IPV during pregnancy were examined. The associations between IPV and WIC participation were analyzed using multiple logistic regression and adjusted odds ratios with corresponding 95% confidence intervals were calculated. Subpopulation analysis was conducted, stratified by race/ethnicity. RESULTS: Nearly half of the study sample received WIC (48.1%), approximately 4% of women reported physical abuse 12 months before their most recent pregnancy, and 3% reported abuse during pregnancy. After adjusting for confounders, women who reported IPV before and during pregnancy had significantly higher odds of WIC utilization compared to women who did not report IPV. However, when stratified by race, the association was only significant for non-Hispanic White women (pre-pregnancy AOR 1.47, 95% CI [1.17, 1.85]; during pregnancy AOR 1.47, 95% CI [1.14, 1.88]). CONCLUSIONS FOR PRACTICE: There is an association between IPV before and during pregnancy and utilization of WIC. Public health professionals and policy makers should be aware of this association and use this opportunity to screen and address the needs of WIC recipients.


Assuntos
Grupos Étnicos/estatística & dados numéricos , Assistência Alimentar/estatística & dados numéricos , Violência por Parceiro Íntimo/estatística & dados numéricos , Gestantes/psicologia , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Lactente , Violência por Parceiro Íntimo/etnologia , Gravidez , Cuidado Pré-Natal , Fatores de Risco , Fatores Socioeconômicos , Estados Unidos , Adulto Jovem
6.
BMC Pregnancy Childbirth ; 19(1): 291, 2019 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-31409286

RESUMO

BACKGROUND: Low-income and minority children are at increased risk for obesity. Text messaging offers advantages for delivering education, but few studies have assessed the acceptability of text messaging in interventions aimed at preventing excessive weight gain in infants. This study investigated the acceptability of a text message-based intervention for prevention of excessive weight gain in infants from Hawai'i and Puerto Rico WIC clinics. METHODS: The four-month text message based intervention designed to improve infant feeding practices and reduce excessive weight gain was a randomized controlled trial that included mothers with infants ages 0-2 months at baseline. Participants in the intervention arm received 18 text messages (1/week) promoting breastfeeding and appropriate complementary feeding. Acceptability of the intervention was assessed from participant retention, satisfaction, and evidence of behavior change in a sequential multimethod approach, quantitatively from questions sent via text and qualitatively during the in-person exit interview. The final analysis included 80 mother-infant pairs from the intervention arm. RESULTS: When asked about messages liked and disliked the most, the majority of responses via text indicated that they liked all messages. From the qualitative analyses, most participants reported that all messages were useful and that the messages led them to make changes in the way they fed their infants. Participant retention was good at 78.4%. CONCLUSIONS: The intervention was acceptable to participants based upon participant retention, measures of satisfaction, and reports of behavior change. Results may inform development of mobile health programs for minority childhood obesity prevention. TRIAL REGISTRATION: ClinicalTrials.gov Identifier; NCT02903186; September 16, 2016.


Assuntos
Aleitamento Materno , Aceitação pelo Paciente de Cuidados de Saúde , Obesidade Pediátrica/prevenção & controle , Mensagem de Texto , Adulto , Comportamento Alimentar , Feminino , Assistência Alimentar , Hawaii , Humanos , Lactente , Recém-Nascido , Masculino , Satisfação do Paciente , Gravidez , Porto Rico , Pesquisa Qualitativa , Ensaios Clínicos Controlados Aleatórios como Assunto , Retenção nos Cuidados , Adulto Jovem
8.
Glob Health Action ; 12(1): 1633725, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31328678

RESUMO

Background: In March 2018, the Government of India launched a direct benefit transfer (DBT) scheme to provide nutritional support for all tuberculosis (TB) patients in line with END TB strategy. Here, the money (@INR 500 [~8 USD] per month) is deposited electronically into the bank accounts of beneficiaries. To avail the benefit, patients are to be notified in NIKSHAY (web-based notification portal of India's national TB programme) and provide bank account details. Once these details are entered into NIKSHAY, checked and approved by the TB programme officials, it is sent to the public financial management system (PFMS) portal for further processing and payment. Objectives: To assess the coverage and implementation barriers of DBT among TB patients notified during April-June 2018 and residing in Dakshina Kannada, a district in South India. Methods: This was a convergent mixed-methods study involving cohort analysis of patient data from NIKSHAY and thematic analysis of in-depth interviews of providers and patients. Results: Of 417 patients, 208 (49.9%) received approvals for payment by PFMS and 119 (28.7%) got paid by 1 December 2018 (censor date). Reasons for not receiving DBT included (i) not having a bank account especially among migrant labourers in urban areas, (ii) refusal to avail DBT by rich patients and those with confidentiality concerns, (iii) lack of knowledge and (iv) perception that money was too little to meet the needs. The median (IQR) delay from diagnosis to payment was 101 (67-173) days. Delays were related to the complexity of processes requiring multiple layers of approval and paper-based documentation which overburdened the staff, bulk processing once-a-month and technological challenges (poor connectivity and issues related to NIKSHAY and PFMS portals). Conclusion: DBT coverage was low and there were substantial delays. Implementation barriers need to be addressed urgently to improve uptake and efficiency. The TB programme has begun to take action.


Assuntos
Assistência Alimentar/organização & administração , Tuberculose/epidemiologia , Adolescente , Adulto , Criança , Pré-Escolar , Estudos de Coortes , Confidencialidade , Feminino , Humanos , Índia , Lactente , Recém-Nascido , Entrevistas como Assunto , Conhecimento , Masculino , Pessoa de Meia-Idade , Adulto Jovem
9.
Artigo em Inglês | MEDLINE | ID: mdl-31344937

RESUMO

In this study, we examined the association between participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and breastfeeding outcomes before and after the 2009 revisions. Four-thousand-three-hundred-and-eight WIC-eligible children younger than 60 months were included from the 2005-2014 National Health and Nutrition Examination Survey (NHANES). We compared two birth cohorts with regard to their associations between WIC participation and being ever-breastfed and breastfed at 6 months. We estimated the average effect of the treatment for the treated to assess the causal effect of WIC participation on breastfeeding based on propensity score matching. The results showed that WIC-eligible participating children born between 2000 and 2008 were significantly less likely than WIC-eligible nonparticipating children to ever receive breastfeeding (p < 0.05) or to be breastfed at 6 months (p < 0.05). Among children born between 2009 and 2014, WIC-eligible participating children were no longer less likely to ever receive breastfeeding compared to WIC-eligible nonparticipating children; the gap remained in breastfeeding at 6-months (p < 0.05). The disparities in prevalence of ever breastfed between WIC-eligible participants and nonparticipants have been eliminated since the 2009 WIC revision. More efforts are needed to improve breastfeeding persistence among WIC-participating mother-infant dyads.


Assuntos
Aleitamento Materno/estatística & dados numéricos , Assistência Alimentar/estatística & dados numéricos , Pré-Escolar , Feminino , Humanos , Lactente , Inquéritos Nutricionais , Pontuação de Propensão
10.
PLoS One ; 14(7): e0219895, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31329629

RESUMO

The Thrifty Food Plan (TFP) is the basis of benefit allocations within the USDA's Supplemental Nutrition Assistance Program (SNAP), which administers nearly $70 billion in benefits to over 42 million people annually. To produce the allocation of food within the TFP, the USDA uses a mathematical optimization model that solves for the daily apportionment across various food groups. The model is constrained by nutritional and consumption requirements to produce an "optimal" allocation. Despite the importance of the TFP, the computational solution developed by the USDA has received insufficient attention, with only a handful of articles written on the TFP optimization model. Here, we run three alternative objective functions that are simpler than the one used by USDA. Our first alternative objective function minimizes the sum of squared errors between the consumed market basket of goods and an allocated market basket of goods, the second alternative objective function minimizes the sum of the absolute value of the difference between the consumed market basket of goods and an allocated market basket of goods, and the third alternative objective function minimizes the weighted absolute deviation of allocations and actual consumption expressed as a proportion of observed consumption. A clear theoretical advantage of either of our methods is that they eliminate the need to arbitrarily set allocated consumption to nonzero values, as is the case for the logarithmic objective function used by USDA. In an operational sense, we find that our model formulations produce an allocation that fits actual consumption better than the objective function employed by the USDA.


Assuntos
Assistência Alimentar/economia , Assistência Alimentar/normas , Humanos , Modelos Estatísticos , Avaliação Nutricional , Recomendações Nutricionais , Estados Unidos , United States Department of Agriculture/economia , United States Department of Agriculture/normas
11.
Rev. bioét. derecho ; (46): 167-183, jul. 2019.
Artigo em Espanhol | IBECS | ID: ibc-184858

RESUMO

Este artículo analiza la situación de los refugiados que llegan a Cataluña. Particularmente, se centra en el vínculo que tiene la alimentación con diversos factores relacionados con la acogida. Para ello, se describen las cifras del movimiento migratorio en Europa, se exponen particularidades del estado de salud del refugiado y se explican las redes de apoyo nutricional en Cataluña y como país de comparación, en los Estados Unidos. Esta investigación busca englobar la información para comprender las luces y las sombras de la integración y dilucidar el papel que tiene en ella la alimentación. Finalmente, se prestan atención a los matices culturales, bioéticos y sociales que construyen los cimientos de la adaptación


This paper analyses the situation of refugees arriving in Catalonia (Spain). In particular, it focuses on the link that food has with various factors related to reception. To this aim, data on the migratory movement in Europe are presented, as well as details of the refugee's state of health and an explanation of the nutritional support networks in Catalonia. This research seeks to encompass information in order to understand the lights and shadows of integration and to elucidate the role of food in it. To this end, attention is paid to cultural, bioethical and social nuances that build the foundations of adaptation


Aquest article analitza la situació de les persones refugiades que arriben a Catalunya (Espanya). Particularment, se centra en el vincle que té l'alimentació amb diversos factors relacionats amb l'acolliment. Per a això, es presenten dades del moviment migratori a Europa, s'exposen particularitats de l'estat de salut del refugiat i s'expliquen les xarxes de suport nutricional a Catalunya. Aquesta recerca busca englobar la informació per a comprendre les llums i les ombres de la integració i dilucidar el paper que té en ella l'alimentació. Per a això, es para esment a matisos culturals, bioètics i socials que construeixen els fonaments de l'adaptació


Assuntos
Humanos , Estratégias de eSaúde , Refugiados/legislação & jurisprudência , Abastecimento de Alimentos , Assistência Alimentar/legislação & jurisprudência , Desnutrição/epidemiologia , Espanha , Aculturação , Apoio Social , Estado Nutricional , Emigrantes e Imigrantes/legislação & jurisprudência
12.
Nutrients ; 11(6)2019 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-31242555

RESUMO

Though fruit and vegetable consumption is essential for disease prevention and health maintenance, intake among children fails to meet dietary recommendations. Limited access to and the affordability of fresh produce, particularly among low-income youth, are barriers to adequate intake. To address these challenges, researchers and pediatricians in Flint, Michigan, expanded a successful fruit and vegetable prescription program that provides one $15 prescription for fresh fruits and vegetables to every child at every office visit. Vendors include the downtown farmers' market and a local mobile market. This study describes baseline characteristics, dietary patterns, food access, and food security among 261 caregiver-child dyads enrolled August 2018-March 2019. The child-reported mean daily intake of vegetables (0.72 cups ± 0.77), dairy products (1.33 cups ± 1.22), and whole grains (0.51 ounces ± 0.49) were well below recommendations. Furthermore, 53% of children and 49% of caregivers who completed the food security module indicated low or very low food security. However, there were no statistically significant differences in the child consumption of fruits and vegetables between households that reported high versus low food security (p > 0.05). Results validate and raise deep concerns about poor dietary patterns and food insecurity issues facing Flint children, many of whom continue to battle with an ongoing drinking water crisis. Additional poverty-mitigating efforts, such as fruit and vegetable prescription programs, are necessary to address these gaps.


Assuntos
Fenômenos Fisiológicos da Nutrição Infantil , Comportamento Alimentar , Abastecimento de Alimentos , Frutas , Estado Nutricional , Valor Nutritivo , Recomendações Nutricionais , Verduras , Adolescente , Fenômenos Fisiológicos da Nutrição do Adolescente , Adulto , Fatores Etários , Criança , Estudos Transversais , Inquéritos sobre Dietas , Feminino , Assistência Alimentar , Humanos , Masculino , Michigan , Pessoa de Meia-Idade , Pobreza , Prescrições , Determinantes Sociais da Saúde
13.
Diabetes Educ ; 45(4): 397-407, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31204590

RESUMO

PURPOSE: The purpose of this study is to explore the associations between food insecurity (FI) and coping strategies of relevance to diabetes self-management among households of people with diabetes (HHDM) who access US food pantry programs. METHODS: The authors conducted a secondary data analysis of HHDM accessing US food pantry programs from the Hunger in America 2014 study (n = 16 826). Weighted analyses included descriptive statistics for household sociodemographics, food pantry service utilization, FI, and coping behaviors. The authors used chi-square and logistic regression to estimate the relationship between FI and coping behaviors. RESULTS: Nearly one-half of HHDM reported visiting food pantries at least 6 times in the past year. Most HHDM were FI, with the majority experiencing the most severe form of FI. Over one-fifth of households reported lacking health insurance. The majority of HHDM reported purchasing inexpensive unhealthy foods to ensure household food adequacy, and many reported watering down food and beverages. The odds of reporting these behaviors significantly increased as FI worsened. CONCLUSION: Food pantries represent an opportunity for the delivery of community-based diabetes self-management education and support programs. These programs should be adapted to address population barriers to self-management and to support access to healthful foods and medical care.


Assuntos
Diabetes Mellitus/psicologia , Características da Família , Assistência Alimentar/estatística & dados numéricos , Abastecimento de Alimentos/estatística & dados numéricos , Autogestão/psicologia , Adaptação Psicológica , Adulto , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Estados Unidos
19.
CMAJ ; 191(20): E552-E558, 2019 05 21.
Artigo em Inglês | MEDLINE | ID: mdl-31113784

RESUMO

BACKGROUND: Household food insecurity, a measure of income-related problems of food access, is a pressing public health problem in Canada's North, especially in Nunavut. We aimed to assess the impact of Nutrition North Canada, a food retail subsidy intended to improve food access and affordability in isolated communities, on household food insecurity in Nunavut. METHODS: Using data from 3250 Nunavut households sampled in the annual components of the Canadian Community Health Survey (2007 to 2016), we conducted interrupted time series regression analyses to determine whether the introduction of Nutrition North Canada was associated with changes in the rates of self-reported food insecurity, according to a validated instrument. We used propensity score weighting to control for several sociodemographic characteristics associated with food insecurity. RESULTS: Food insecurity affected 33.1% of households in 2010 (the year before the launch of Nutrition North Canada), 39.4% of households in 2011 (the year of the launch) and 46.6% of households in 2014 (the year after full implementation). After controlling for several covariates, we found the rate of food insecurity increased by 13.2 percentage points (95% confidence interval [CI] 1.7 to 24.7) after the full implementation of the subsidy program, and the increase in food insecurity first occurred in 2011 (9.6 percentage points, 95% CI 2.7 to 16.4), the year Nutrition North Canada was launched. INTERPRETATION: Food insecurity was a pervasive problem in Nunavut before Nutrition North Canada, but it has become even more prevalent since the program was implemented. Given the important health consequences of food insecurity, more effective initiatives to address food insecurity in Canada's North are urgently needed.


Assuntos
Assistência Alimentar/estatística & dados numéricos , Abastecimento de Alimentos/estatística & dados numéricos , Adolescente , Adulto , Idoso , Criança , Comércio/estatística & dados numéricos , Características da Família , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nunavut , Estado Nutricional , Fatores Socioeconômicos , Adulto Jovem
20.
Artigo em Inglês | MEDLINE | ID: mdl-31117216

RESUMO

Household food insecurity is a serious public health concern in rich countries with developed economies closely associated with inequality. The prevalence of household food insecurity is relatively high in some developed countries, ranging from 8 to 20% of the population. Human rights approaches have the potential to address the structural causes, not just the symptoms of food insecurity. Despite most developed countries ratifying the Covenant on Economic, Social and Cultural Rights over 40 years ago, food insecurity rates suggest current social protections are inadequate. The contemporary framing of the solution to food insecurity in developed countries is that of diverting food waste to the hungry to meet the United Nations Sustainable Development Goals agenda (Goals 2 and 12.3). An estimated 60 million people or 7.2% of the population in high income countries used food banks in 2013. Although providing food assistance to those who are hungry is an important strategy, the current focus distracts attention away from the ineffectiveness of government policies in addressing the social determinants of food insecurity. Much of the action needed to improve household food security falls to actors outside the health sector. There is evidence of promising actions to address the social determinants of food insecurity in some developed countries. Learning from these, there is a strong case for government leadership, for action within and across government, and effective engagement with other sectors to deliver a coordinated, collaborative, and cooperative response to finding pathways out of food insecurity.


Assuntos
Países Desenvolvidos , Assistência Alimentar , Abastecimento de Alimentos , Fome , Fatores Socioeconômicos , Humanos , Renda
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