Hugo Melgar-Quinonez

Correlates of Fruit and Vegetable Intakes in US Children

The objective of this study was to assess the quality of the current intakes of fruits and vegetables compared to the Dietary Guidelines for Americans in US children and adolescents and identify factors related to low fruit and vegetable intake. This descriptive study examined differences in fruit and vegetable intakes by age, sex, ethnicity, poverty level, body mass index, and food security status utilizing data from the 1999-2002 National Health and Nutrition Examination Survey. Six thousand five hundred thirteen children and adolescents ages 2 to 18 years, who were respondents to the 1999-2002 National Health and Nutrition Examination Survey. Mean fruit and vegetable intakes were computed using 24-hour recalls for individuals and compared using analysis of variance. Leading contributors to fruit and vegetable intake were identified using frequency analysis. Children aged 2 to 5 years had significantly higher total fruit and juice intakes than 6- to 11- and 12- to 18-year-olds. Total vegetable and french fry intake was significantly higher among 12- to 18-year-old adolescents. Regarding sex differences, boys consumed significantly more fruit juice and french fries than girls. In addition, non-Hispanic African-American children and adolescents consumed significantly more dark-green vegetables and fewer mean deep-yellow vegetables than Mexican-American and non-Hispanic white children and adolescents. Total fruit consumption also differed significantly among race/ethnicities and household income. Children and adolescents most at risk for higher intakes of energy-dense fruits and vegetables (fruit juice and french fries) were generally boys, and adolescents, at risk for overweight or overweight and living in households below 350% of the poverty level.

Food Security and Nutritional Outcomes of Preschool-Age Mexican-American Children

OBJECTIVE To examine the relationship of food insecurity to nutrition of Mexican-American preschoolers. DESIGN Cross-sectional survey of low-income Mexican-American families with children of preschool age (3 to 6 years). Data included food security using the Radimer/ Cornell scale; acculturation; parental education; monthly income; past experience of food insecurity; and child weight, height, and frequency of consuming 57 foods. Weight-for-height z scores (WHZ), height- for-age z (HAZ) scores, and the percentage of overweight (> or = 85th percentile WHZ) were calculated. SUBJECTS/SETTING A convenience sample of Mexican-American families (n=211) was recruited through Head Start, Healthy Start, Migrant Education, and the Special Supplemental Nutrition Program for Women, Infants, and Children in Tulare, Fresno, Monterey, and Kern counties in California. Statistical analyses Analysis of variance, t tests, Spearmans correlations, and Mantel Haenszel chi2. RESULTS Limited education, lack of English proficiency, and low income were negatively correlated with food security (r = -0.31 to -0.44, P<.0001). After controlling for acculturation, children in severely food-insecure households were less likely to meet Food Guide Pyramid guidelines than other children (median number of food groups > or = recommended levels [interquartile range]: 2.0 (2.0) vs 3.0 (2.0), P<.006). Although WHZ (mean +/- SD = 1.28 +/- 1.80) and percent overweight (48%, N=19) tended to peak among children from household level food insecure families, no significant differences were found in weight or height status of children by level of food insecurity. APPLICATIONS/CONCLUSIONS Dietetics professionals working with low-income Hispanic-American families should screen for different levels of food insecurity to determine needs for nutrition education and other services.

Food Insecurity and Food Supplies in Latino Households with Young Children

OBJECTIVE To examine the relationship between food insecurity and food supplies in Latino households. DESIGN Cross-sectional survey, conducted February to May 2001. SETTING Six California counties. PARTICIPANTS Convenience sampling was used to recruit 274 low-income Latino families with preschool children from the Special Supplemental Nutrition Program for Women, Infants and Children (WIC), Head Start, and other community-based organizations. Complete data were available for 256 families. VARIABLES MEASURED Food security, household food scores. ANALYSIS Pearson correlations, Kruskal-Wallis test, and logistics regression. Significance level at P <.05. RESULTS Controlling for maternal education, food insecurity over the past 3 months was associated with lower household food supplies: dairy, r = -.18, P <.01; fruit, r = -.36, P <.001; grains, r = -.27, P <.0001; meats, r = -.22, P <.001; snack foods, r = -.23, P <.001; and vegetables, r = -.29, P <.001. CONCLUSIONS AND IMPLICATIONS In Latino households, greater food insecurity is associated with a lower variety of most foods, particularly fruits and vegetables. Future research in Latino households should explore the effects of seasonal food insecurity and household food shortages on food intake of individual household members, especially young children.

Validación de escala de la seguridad alimentaria doméstica en Antioquia, Colombia

Objective. To adapt and validate in households of Antioquia, Colombia, a food security scale previously applied in households of Caracas, Venezuela. Material and Methods. The study was carried out in 44 municipalities in the department of Antioquia, Colombia, in 2003 and 2004, with a randomly selected sample of 1 624 rural and urban households with children under 10 years of age, representative for family units located in the department of Antioquia. The sample was selected using a confidence interval of 95% and an error of 3%. Household food security scale previously used by Paulina Lorenzana in Venezuela were validated for this survey. Internal consistency of the scale was determined using the Spearman correlation coefficient and Cronbach’s Alpha coefficient. Construct validity was established through principal components analysis for categorical data. Prinqual procedure and Rasch modeling were used to define the components and items in the scale. Results. Factor analysis showed two components: 1) variables related to “food insecurity without hunger”, which is explained in 95%; 2) variables related to “food insecurity with hunger”, which is explained in 89.4%. Cronbach’s Alpha coefficients for “food insecurity without hunger” and “food insecurity with hunger” were 0.95 and 0.89, respectively. When analyzed using Rasch modeling, all items showed infit values within a range of 0.8 and 1.2. The scale correlated significantly (p<0.000) with food availability, begging, children’s labor, household size,

Acculturation of Mexican-American mothers influences child feeding strategies

OBJECTIVE The purpose of this study was to examine the influence of maternal acculturation level on child feeding strategies and anthropometry in preschoolers from low-income Mexican-American families. DESIGN/SUBJECTS Data are from a cross-sectional survey of 238 low-income Mexican-American families with preschool children living in California during 1998. Interviewers collected data from the mothers on child-feeding practices and weighed and measured the children in their homes. STATISTICAL ANALYSES Spearmans correlation coefficients, analysis of variance, and chi 2 were used to examine the relationship pf maternal acculturation level with feeding strategies and anthropometric measurements. RESULTS Compared with more acculturated mothers, less acculturated mothers tend to offer alternative foods more often when their children refuse to eat. More acculturated women are less likely to view bribes, threats, and punishments as effective strategies and are more likely to give vitamins than less acculturated mothers. Maternal acculturation is not associated with differences in weight-for-height z-scores, height-for-age, or body mass index of the children. Triceps skinfold thickness are larger in children of more acculturated mothers than in children of less acculturated women. APPLICATIONS/CONCLUSIONS Dietitians should consider differences in child feeding practices due to acculturation among Mexican-Americans. Successful strategies to encourage consumption of nutritious traditional foods and to transition from child-led snacking to more structured meals should be part of nutrition education programs.

Psychometric properties of a modified US-household food security survey module in Campinas, Brazil

Objective:To assess the internal validity of a multiple-item measure of household food security in Brazil using statistical methods based on the single-parameter logistic (Rasch) measurement model.Subjects/Methods:Sample of the non-institutionalized civilian population living in the municipality of Campinas selected using stratified cluster sampling. Of the 1000 households randomly chosen, 847 responded to the interview. Responses to each of the 15 questions were coded into dichotomous items indicating whether the specific food-insecure condition had occurred (other than in just 1 or 2 days) during the 3 months before the survey. Scaling analyses were conducted separately as well as jointly for adult/household-related items and child-related items. Item-fit statistics were examined to determine the extent to which the items appear to measure the same underlying phenomenon, and item severity scores were compared with those of equivalent items in the US Current Population Survey.Results:Except for one item, infit statistics were within a range considered adequate (0.80–1.2), indicating a common phenomenon being measured with approximately equal discrimination. The relative severites of the items in the Campinas survey were generally similar to those of equivalent items in the US Current Population Survey. Analysis of all 15 items together indicates a higher severity level for child-related items compared with equivalent adult-related items.Conclusions:This analysis will serve as the prototype for confirming the psychometric validity of a food insecurity scale at a national level.

Household food insecurity associated with stunting and underweight among preschool children in Antioquia, Colombia

OBJECTIVE To assess criterion validity of a household food security scale through its associations with child health status in participants of the Colombian Plan for Improving Food and Nutrition in Antioquia (Mejoramiento Alimentario y Nutricional de Antioquia (MANA)). METHODS A 12-item household food security survey (Colombian Household Food Security Scale, CHFSS) was applied to a cross-sectional stratified random sample of 2 784 low-income households with preschool children receiving MANA food supplements in Antioquia, Colombia. Anthropometrics and health status of the children were also assessed. Chi-square tests were used to initially compare child health status and household food security status. Logistic regression models were further developed to assess this relationship in bivariate and multiple regression models. RESULTS Statistically significant associations were found between household food insecurity and diagnoses of childrens diarrhea, respiratory infections, and parasitosis (P < 0.0001). The risk for child stunting and underweight increased in a dose-response way as food insecurity became more severe. CONCLUSIONS Our research establishes an important link between household food insecurity and child nutritional status in participants of a food assistance program. The results affirm the criterion validity of the CHFSS, establishing the proposed instrument as a valid measure for food insecurity with high-risk populations.

Validación de un instrumento para vigilar la inseguridad alimentaria en la Sierra de Manantlán Jalisco

OBJETIVO: Validar una version de la Escala de Seguridad Alimentaria (FSS) en comunidades de la Sierra de Manatlan, Jalisco. MATERIAL Y METODOS: Usando grupos focales se modifico la FSS. Posteriormente se aplico una encuesta a mujeres con ninos preescolares. La FSS se valido correlacionandola con el inventario de alimentos del hogar y con la variedad de dieta de la entrevistada. La encuesta incluyo un cuestionario socio-economico. RESULTADOS: El 44% de los hogares indicaron inseguridad alimentaria leve, 33% hambre moderada y 19.7% hambre severa. La inseguridad alimentaria estuvo inversamente correlacionada con el inventario de alimentos (r=-0.36**), alimentos de origen animal (r=-0.28**), lacteos (r=-0.25**), alimentos procesados (r=-0.37**), frutas (r=-0.21*) y verduras (r=-0.28**); *p<0.05, **p< 0.01. La inseguridad alimentaria estuvo asociada a la baja variedad de dieta (r=-0.23; p=0.02). Estas asociaciones se mantuvieron en modelos multivariados. CONCLUSIONES: La FSS es un instrumento util para vigilar la inseguridad alimentaria en zonas rurales de Jalisco.

Measuring household food security: the global experience

Measuring household food insecurity represents a challenge due to the complexity and wide array of factors associated with this phenomenon. For over one decade, researchers and agencies throughout the world have been using and assessing the validity of variations of the United States Department of Agriculture Household Food Security Supplemental Module. Thanks to numerous studies of diverse design, size, and purpose, the Household Food Security Supplemental Module has shown its suitability to directly evaluate the perceptions of individuals on their food security status. In addition, challenges and limitations are becoming clearer and new research questions are emerging as the process advances. The purpose of this article is to describe the development, validation procedures, and use of the Household Food Security Supplemental Module in very diverse settings. The most common Household Food Security Supplemental Module related studies have been conducted using criterion validity, Rasch modeling and Cronbach-Alpha Coefficient. It is critical that researchers, policy makers, governmental and non-governmental agencies intensify their efforts to further develop tools that provide valid and reliable measures of food security in diverse population groups. Additional work is needed to synthesize a universally applicable tool able to capture the global human phenomenon of food insecurity.

Gender of respondent does not affect the psychometric properties of the Brazilian Household Food Security Scale

BACKGROUND Food insecurity is a major public concern that occurs when nutritional needs are not met, incorporates psychological and physiological coping mechanisms, and can range from basic concern over obtaining food to severe malnutrition. This study was performed to explore differences in female and male respondent psychometric characteristics of a locally adapted Brazilian Household Food Security Scale (Escala Brasileira de Medida da Insegurança Alimentar--EBIA). METHODS The 16-item EBIA was incorporated into the 2004 Brazilian National Household Sample Survey 2004 (Pesquisa Nacional por Amostra de Domicílios--PNAD; n = 108 606). Rasch Modelling was used to evaluate survey one-dimensionality, construct and independence through analysis of infit and relative item severities of adult and children items by gender. Differences in estimated item severities between male and female respondents were assessed using Differential Item Functioning (DIF) models. RESULTS The scale presented good fitness and most item infit values were within adequate range (0.8-1.2), being practically identical when comparing female and male responses. Both female and male respondents presented similar relative item severities for adult and children items and followed the same pattern of increasing relative item severities with each item in the questionnaire. None of the items presented substantial DIF. CONCLUSIONS This research demonstrates that the psychometric properties of the EBIA are not affected by respondent gender in Brazil. The results of this study support the validity of the proposed scale, suggesting that the scale will provide accurate information regardless of respondent gender for governments, researchers and agencies concerned with reducing epidemic levels of food insecurity and the resulting health disparities.