Opening the box: intrahousehold food allocation in rural Nepal.

The study examined intrahousehold food behavior in six villages in a rural hill area of mid-Western Nepal. Qualitative and quantitative methodologies taken from both anthropology and nutritional sciences were used to collect data on food belief systems, household allocation of food resources, and the effect of these features on diet and anthropometric status in a sample of 767 individuals in 115 households. Background data were also collected on socioeconomic status and demographic variables such as education levels, occupation, and migration patterns. The core methodological approach used direct structured observations of meals to examine how food is distributed within households. The results document a variety of mechanisms by which some individuals are favored over others through household food distribution, including serving order, serving method, refusing to serve foods, channeling foods and substituting low status foods for high status foods. No differences were observed in mechanisms of food distribution or nutrient intake between male and female children, contrary to evidence in the literature suggesting that male children will be favored. On the other hand, adult women were less likely to meet their nutrient requirements for energy, beta-carotene, riboflavin, and vitamin C than men of the same age. Women's late position in household serving order, channeling of special foods to males and children, and lower total intake of food accounts for these findings.     

Gender, marital status, and commercially prepared food expenditure

ObjectiveAssess how per capita expenditure on commercially prepared food as a proportion of total food expenditure varies by the sex and marital status of the head of the household.DesignProspective cohort study, data collected by the United States Bureau of Labor Statistics 2004 Consumer Expenditure Survey.SettingUnited States.ParticipantsRandomly selected nationally representative sample of 5744 US citizens.Main Outcome MeasuresPer capita spending on commercially prepared food (dependent variable) for every $1 increase in total per capita food spending (independent variable).AnalysisLinear regressions run separately for each permutation of gender and marital status (never married, married, divorced/separated).ResultsProportionate per capita household expenditure on commercially prepared food was found to vary by marital status and gender. Households headed by unmarried men (both divorced/separated and never married) spent a significantly greater proportion of their food budget on commercially prepared food than their married male peers (38% and 60% higher, respectively). Regardless of marital status, households headed by women were found to spend approximately one-third of their total food budget on commercially prepared foods outside the home. Households headed by never married men spent 63% more per capita than those headed by never married women and households headed by divorced or separated men spent 37% more than those headed by divorced or separated women.Conclusions and ImplicationsMarital status is significantly related to the dietary patterns of households headed by men. In light of the high rates of divorce, separation, and delay of marriage, marriage cannot be considered an inclusive or permanent solution to changing male eating patterns. It is important that nutrition educators learn more about the dietary patterns of households headed by males outside the institution of marriage.     

Psychosocial determinants of food purchasing and preparation in American Indian households

OBJECTIVE: Obesity and other diet-related chronic diseases affect American Indians at high rates, yet little is known about food use behaviors in this population, or of psychosocial factors that influence these behaviors. The study objective was to address this gap. DESIGN: Cross-sectional; part of baseline collection for an intervention trial. SETTING: White Mountain and San Carlos Apache reservations, Arizona. PARTICIPANTS: Main household food shoppers and preparers of 270 randomly selected households on two American Indian reservations. ANALYSIS: Multivariate linear regression. VARIABLES MEASURED: Primary independent variables were healthy food knowledge, self-efficacy and intentions, assessed using multi-question scales. Dependent variables were frequency of purchasing healthy foods and a healthiness of cooking methods score. RESULTS: Higher-fat and/or higher-sugar items were commonly purchased, with limited purchasing of healthier alternatives. Pre-prepared foods are a substantial component of the diet. Cooking methods which add or have little impact on the fat content of foods were more commonly employed than methods which reduce fat. Food acquisition and use behaviors were predicted by food use intentions. Food intention scores were predicted by food self-efficacy; food self-efficacy by food knowledge. CONCLUSIONS AND IMPLICATIONS: These findings support the use of food knowledge, self-efficacy, and intentions in understanding food-related behavior in this setting.     

Effect of sociodemographic variables and time on food group contribution to total food availability in Portuguese elderly households

Objective

To analyze the simultaneous effects of sociodemographic variables and time on each food group contribution to total Portuguese elderly household food availability.

Design

Four cross sectional Portuguese Household Budget Surveys were used. A multivariate analysis of variance (MANOVA), using a general linear model (GLM), was applied to analyze the simultaneous effects of sociodemographic variables and time.

Setting

Portuguese population.

Subjects

Nationally representative samples of households with members aged ≥ 65 years were selected and categorized as solitary elderly female, solitary elderly male, or couple (one elderly female and one elderly male). Samples included 1,967 households in 1989–1990, 2,219 households in 1994–1995, 2,533 households in 2000–2001 and 2,441 households in 2005–2006.

Results

The simultaneous effects of sociodemographic variables and time were significant for all food groups (P<0.001). The highest contribution for the total household food availability was found for cereals, potatoes, alcoholic beverages, nonalcoholic beverages and fruits. The effects were large for “household food availability” and medium for “elderly household type”, “urbanization degree”, “income”, “food expenses” and “eating out expenses”. Solitary elderly male households had the highest proportion of cereals and alcoholic beverages, whilst solitary elderly female households had higher availability of milk/milk products and fruits. Households located in urban areas had higher contribution of milk/milk products while rural, had higher contribution of potatoes.

Conclusions

The simultaneous effect of the studied variables on food group contribution to total household food availability can be considered when addressing dietary recommendation for providing an insight into the motivations associated with food purchases.     

Quantitative indicators from a food expenditure survey can be used to target the food insecure in South Africa

Recent work on assessing household food insecurity has focused mainly on experiential-based measures using qualitative survey questions. In this paper, we employed two quantitative measures to estimate prevalence rates for household food insecurity in South Africa. One measure, termed food poverty, assessed whether the amount spent by a household on food was inadequate to purchase a low cost food plan. Low energy availability assessed whether the food energy available to a household, through its purchases and home production, was less than the sum of its members' recommended energy intakes. The 1995 Income and Expenditure Survey, a large representative survey of South African households (n = 28,704), was used for this secondary data analysis. Results showed that 43% of households were in food poverty in October 1995, and 55% had a low energy availability. These indicators allowed classification of households into four groups: food poverty only; low energy availability only; food insecure on both measures; and food secure. These groups differed on various aspects of household food consumption, suggesting that these indicators can be used to target different types of interventions to meet specific needs. Both bivariate and multivariate analyses showed that households that were food insecure on both measures were more likely to be in rural areas, have low incomes or large household sizes, and be headed by Africans or individuals of mixed ancestry. These patterns of food insecurity were corroborated by previous research on income poverty and nutritional status, suggesting that food poverty and low energy availability are useful, quantitative indicators for assessing food insecurity in South Africa.     

Efficiency of breakfast consumption patterns of ninth graders: nutrient-to-cost comparisons

OBJECTIVE: To assess the efficiency of breakfast consumption patterns in terms of nutrient-to-cost comparisons. DESIGN: Twenty-four-hour dietary recalls were collected and food items named were priced (prices from local grocery stores and restaurants were averaged). Three breakfast consumption groups were identified: restaurant foods (fast foods), ready-to-eat (RTE) cereal, and other foods. SUBJECTS: Subjects consisted of 567 ninth-grade students (57% female, 86% white, mean age 14.8 years) in New Orleans, La. STATISTICAL ANALYSES: Analysis of variance techniques were used to test statistical significance for total nutrient intake levels, intake levels of nutrients per 1,000 kcal, and nutrient intake levels per dollar spent. Groupings were determined using the Duncan test or pairwise comparisons. RESULTS: Five percent of students ate a fast-food breakfast, 30% ate RTE cereal, and 65% ate other breakfasts. The mean cost of the breakfast meals was significantly (P<.0001) higher for the fast-food breakfast than for the RTE cereal breakfast and the other breakfast (fast>other=RTE). For every dollar spent, the RTE cereal and other breakfasts provided significantly more energy, carbohydrate, fiber, sugar, and protein than the fast-food breakfast. The other breakfast provided significantly (P<.001) more total and saturated fat per dollar than the fast-food or RTE cereal breakfasts. The RTE cereal breakfast provided significantly (P<.001) more, per dollar spent, of folic acid, iron, niacin, vitamins A and D, and zinc than the other 2 breakfast meals. APPLICATIONS: The importance consumers place on taste, cost, and convenience continues to influence types of foods consumed. Yet, their food choices may not be as efficient in terms of the nutrients obtained per dollar spent. With the increasing demands being placed on families and the decreasing amount of time being spent on food preparation, nutrition education programs should continue to promote a higher level of efficient food choices.     

Socio-demographic influences on food purchasing among Canadian households

OBJECTIVE: To characterize the relationships between selected socio-demographic factors and food selection among Canadian households. DESIGN: A secondary analysis of data from the 1996 Family Food Expenditure survey was conducted (n=10,924). Household food purchases were classified into one of the five food groups from Canada's Food Guide to Healthy Eating. Parametric and non-parametric modelling techniques were employed to analyse the effects of household size, composition, income and education on the proportion of income spent on each food group and the quantity purchased from each food group. RESULTS: Household size, composition, income and education together explained 21-29% of the variation in food purchasing. Households with older adults spent a greater share of their income on vegetables and fruit (P<0.0001), whereas households with children purchased greater quantities of milk products (P<0.0001). Higher income was associated with purchasing more of all food groups (P<0.0001), but the associations were nonlinear, with the strongest effects at lower income levels. Households where the reference person had a university degree purchased significantly more vegetables and fruit, and less meat and alternatives and 'other' foods (P<0.0001), relative to households with the lowest education level. CONCLUSIONS: Household socio-demographic characteristics have a strong influence on food purchasing, with the purchase of vegetables and fruit being particularly sensitive. Results reinforce concerns about constraints on food purchasing among lower income households. Furthermore, the differential effects of income and education on food choice need to be considered in the design of public health interventions aimed at altering dietary behaviour.     

Monitoring food and nutrient availability in a nationally representative sample of Bolivian households

The study objective was to estimate food and nutrient availability in Bolivian households using data from the nationally representative under the Programme for the household surveys undertaken yearly from 1999 to 2002 Improvement of Surveys and the Measurement of Living Conditions in Latin America and the Caribbean (MECOVI). In the present study, we analysed data from four repeated, cross-sectional surveys and applied European Data Food Networking (DAFNE) methodology for post-harmonising the data. Raw data of 19 483 households in Bolivia (3035 in 1999, 4857 in 2000, 5845 in 2001 and 5746 in 2002) were retrieved from the databases of the national household surveys. Results showed that the Bolivian diet is characterised by higher availability of foods of plant origin (cereals, fruits, potatoes and vegetables). Meat, milk and their products follow in the dietary preferences of Bolivians. Disparities in food availability within the country were also observed. Rural households systematically recorded lower amounts of food available, in comparison with the urban ones. Households of higher social status recorded higher availability values for all food groups, except for potatoes and cereals. Findings suggest that Bolivian households of lower socio-economic status prefer energy-dense and cheaper food sources. We concluded the dietary and socio-demographic data collected in the MECOVI household surveys could serve nutrition surveillance purposes. In addition, the application of DAFNE methodology for post-harmonising the data allows both national and international comparisons.     

Nutrient-dense food groups have high energy costs: an econometric approach to nutrient profiling

Consumers wishing to replace some of the foods in their diets with more nutrient-dense options need to be able to identify such foods on the basis of nutrient profiling. The present study used nutrient profiling to rank 7 major food groups and 25 subgroups in terms of their contribution to dietary energy, diet quality, and diet cost for 1332 adult participants in the French National INCA1 Study. Nutrient profiles were based on the presence of 23 qualifying nutrients, expressed as the percentage of nutrient adequacy per 8 MJ, and 3 negative or disqualifying nutrients, expressed as the percentage of the maximal recommended values for saturated fatty acids, added sugar, and sodium per 1.4 kg. Calculated cost of energy (euro/8 MJ) was based on the mean retail price of 619 foods in the nutrient composition database. The meat and the fruit and vegetables food groups had the highest nutritional quality but were associated with highest energy costs. Sweets and salted snacks had the lowest nutritional quality but were also one of the least expensive sources of dietary energy. Starches and grains were unique because they were low in disqualifying nutrients yet provided low-cost dietary energy. Within each major food group, some subgroups had a higher nutritient-to-price ratio than others. However, the fact that food groups with the more favorable nutrient profiles were also associated with higher energy costs suggests that the present structure of food prices may be a barrier to the adoption of food-based dietary guidelines, at least by low-income households.     

Analysis of household expenditures with food in the city of S. Paulo in the 1990's

OBJECTIVE: To identify food consumption patterns in the city of S. Paulo, from 1990 to 1996, and compare these patterns with those derived from nutritionally balanced food baskets (FB). METHODS: Household budget surveys were verified and the percentage of food expenditures was assessed according to three food groups: semi-elaborated, industrialized and non-processed food (an emphasis was given to this group). Data on prices to consumer were used to evaluate the relative cost of the products and their influence on household budgets. FB were elaborated using linear programming. RESULTS: From 1990 to 1996, there was a relative increase in household expenditures with industrialized foods and a relative decrease with semi-elaborated foods. The percentage of expenditures with non-processed group revealed an important reduction (35%), but these changes cannot be fully explained by variations in products' prices. Results indicated that household consumption patterns differ from those recommended in the FB and the cost of almost all FB was lower than the actual household expenditures with food. CONCLUSIONS: An inadequate nutritional consumption in S?o Paulo's households is probable, which carry the risks associated with an insufficient ingestion of vegetables and fruits.     

Country food sharing networks,household structure,and implications for understanding food insecurity in Arctic Canada

We examine the cultural context of food insecurity among Inuit in Ulukhaktok, Northwest Territories, Canada. An analysis of the social network of country food exchanges among 122 households in the settlement reveals that a household’s betweenness centrality—a measure of brokerage—in the country food network is predicted by the age of the household. The households of married couples were better positioned within the sharing network than were the households of single females or single males. Households with an active hunter or elder were also better positioned in the network. The households of single men and women appear to experience limited access to country food, a considerable problem given the increasing number of single-adult households over time. We conclude that the differences between how single women and single men experience constrained access to country foods may partially account for previous findings that single women in arctic settlements appear to be at particular risk for food insecurity.     

Nutrient Profile of Household Food Supplies of Families with Young Children

Currently, little is known about the home food environment. This cross-sectional study was designed to describe the food sources of calories and key nutrients in the households of 100 families with at least one child aged 12 years or younger and compare nutrient availability to recommended levels. Participating households were food secure, ate dinner at home at least three times weekly, had parents who were married or living as domestic partners and not employed in a health-related profession, and resided in New Jersey. Researchers visited each household once during 2006/2007 to inventory all foods except alcoholic beverages, commercial baby food, infant formula, pet foods, refrigerated leftovers, foods of minimal nutrient and calorie content, condiments typically consumed in small quantities per eating occasion, and bulk supplies of staples. Inventories were taken using commercial diet analysis software customized to use barcode scanners for foods with standard barcodes and keyword searches for foods lacking barcodes. Protein, carbohydrate, and fat in the households supplied an average of approximately 15%, 57%, and 29% of calories, respectively. Saturated fat and total sugar accounted for an average of approximately 10% and 20%, respectively, of calories. Mean nutrient adequacy ratio for nutrients recommended to be maximized (ie, vitamins A and C, protein, dietary fiber, iron, calcium) was less than optimal, and mean ratio for those recommended to be minimized (ie, total fat, cholesterol, sodium, and sugar) exceeded recommendations. Categorization by food group revealed that the greatest availability of calories, carbohydrates, dietary fiber, total sugar, sodium, and iron was from grains. The greatest availability of total fat, cholesterol, and protein was from meat/protein foods. Dairy products contained the greatest quantities of saturated fat and calcium. This study expands the limited research on the home food supply and provides insights that may have important implications for health-promotion interventions.     

Household food insecurity and food expenditure in Bolivia, Burkina Faso, And the Philippines

This study examined the association between food insecurity, determined by a modified version of the U.S. Household Food Security Survey Module (US HFSSM), and total daily per capita (DPC) consumption (measured as household expenditures) in Bolivia, Burkina Faso, and the Philippines. Household food insecurity was determined by an adapted 9-item US HFSSM version. A short version of the World Bank's Living Standards Measurement Study (LSMS) consumption module measured household expenditures. Focus groups were used to adapt the survey instrument to each local context. The sample (n approximately 330 per country) includes residents of urban and rural areas. A 12-month food expenditure aggregate was generated as part of the total household expenditures calculation. DPC food expenditure, which represented over 60% of the total household consumption, as well as expenditures on specific food groups correlated with food insecurity both as a continuous Food Insecurity Score (FinSS) and a tricategorical food insecurity status variable. ANOVA and regression analysis were executed adjusting for social and demographic covariates. Food-secure households have significantly higher (P < 0.05) total DPC food expenditures as well as expenditures on animal source foods, vegetables, and fats and oils than moderately and severely food-insecure households. The results offer evidence that the US HFSSM is able to discriminate between households at different levels of food insecurity status in diverse developing world settings.     

Dietary sodium intake of infants fed commercially prepared baby food and table food

Sodium intake of infants varies widely with the type of food consumed. However, few reports are available describing the nutrients, including sodium values, of dietary intakes of infants receiving supplemental foods. The purpose of this study was to determine the sodium, energy, and nutrient values of diets for infants from low-income families participating in the WIC program. The sample consisted of 306 infants, aged 4 through 7 months, who were seen in well-child clinics. Approximately 200 of the infants were reportedly fed commercially prepared baby food as the only solid food; 55 received 50% or more of their energy from table foods. The dietary intakes of infants receiving supplemental foods and consuming commercially prepared baby foods included significantly less sodium than the intakes of infants fed primarily table foods. As a group, all infants met the RDAs for most nutrients but had higher sodium values than reported by other researchers. The group of infants for whom consumption of table foods was reported had values above the acceptable range for sodium primarily because the caregivers failed to provide low-sodium, nutrient-dense, supplemental foods in the quantities prescribed but instead substituted sodium-dense meat and vegetable products.     

Predictors and outcomes of household food insecurity among inner city families with preschool children in Vancouver

OBJECTIVES: The purposes of this study were to measure household food security and to determine its association with potential predictor variables related to household and community environments, as well as the relationship between household food insecurity and preschool children's nutritional status. METHODS: In this cross-sectional study, household food security was measured in a convenience sample of households (n=142) with children aged 2-5 years in Vancouver in March 2004. We assessed the association between environmental predictors and household food security status, adjusted for household income. Indicators of children's nutrition were compared between categories of household food security. RESULTS: Household food insecurity was associated with indicators of suboptimal health status in preschoolers. After controlling for household income, parents with less access to food of reasonable quality, fewer kitchen appliances and a lower rating of their cooking skills had greater odds of experiencing household food insecurity. IMPLICATIONS: Our study results support the need to test interventions involving collaborative efforts among government, social planners and public health practitioners to remove barriers to food security for families. Multiple measures, including opportunities to gain practical food skills and household resources that enable convenient preparation of nutrient-dense foods, could be examined. Our findings suggest the need for improved selection and quality at existing small stores and an increase in the number of food outlets in low-income neighbourhoods.     

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.     

Expenditure dispersion and dietary quality: evidence from Canada

This paper examines links between the way in which a household spreads their food expenditure over time and the dietary quality of the food they purchase. I find that households who make more frequent, smaller food purchases buy healthier foods than households who make fewer, larger purchases. These households are more likely to purchase foods with a lower share of total calories from fats, saturated fats and a larger share of calories from fruits and vegetables. The analysis is extended using quantile regression. The effect of expenditure dispersion is found to be largest among households with poor diets i.e. those households with diets high in saturated fats and low in fruits and vegetables.     

Diet Diversity in Pastoral and Agro-pastoral Households in Ugandan Rangeland Ecosystems

We explore how diet diversity differs with agricultural seasons and between households within pastoral and agro-pastoral livelihood systems, using variety of foods consumed as a less complex proxy indicator of food insecurity than benchmark indicators like anthropometry and serum nutrients. The study was in the central part of the rangelands in Uganda. Seventy nine households were monitored for three seasons, and eight food groups consumed during a 24 hour diet recall period used to create a household diet diversity score (HDDS). Mean HDDS was 3.2, varied significantly with gender, age, livelihood system and season (p < .001, F = 15.04), but not with household size or household head’s education level. Agro-pastoralists exhibited lower mean diet diversity than pastoralists (p < .01, F = 7.84) and among agro-pastoralists, households headed by persons over 65 years were most vulnerable (mean HDDS 2.1). This exploratory study raises issues requiring further investigation to inform policies on nutrition security in the two communities.     

Household food insecurity and coping strategies in a poor rural community in Malaysia

This cross-sectional study assessed household food insecurity among low-income rural communities and examined its association with demographic and socioeconomic factors as well as coping strategies to minimize food insecurity. Demographic, socioeconomic, expenditure and coping strategy data were collected from 200 women of poor households in a rural community in Malaysia. Households were categorized as either food secure (n=84) or food insecure (n=116) using the Radimer/Cornell Hunger and Food Insecurity instrument. T-test, Chi-square and logistic regression were utilized for comparison of factors between food secure and food insecure households and determination of factors associated with household food insecurity, respectively. More of the food insecure households were living below the poverty line, had a larger household size, more children and school-going children and mothers as housewives. As food insecure households had more school-going children, reducing expenditures on the children''s education is an important strategy to reduce household expenditures. Borrowing money to buy foods, receiving foods from family members, relatives and neighbors and reducing the number of meals seemed to cushion the food insecure households from experiencing food insufficiency. Most of the food insecure households adopted the strategy on cooking whatever is available at home for their meals. The logistic regression model indicates that food insecure households were likely to have more children (OR=1.71; p<0.05) and non-working mothers (OR=6.15; p<0.05), did not own any land (OR=3.18; p<0.05) and adopted the strategy of food preparation based on whatever is available at their homes (OR=4.33; p<0.05). However, mothers who reported to borrow money to purchase food (OR=0.84; p<0.05) and households with higher incomes of fathers (OR=0.99; p<0.05) were more likely to be food secure. Understanding the factors that contribute to household food insecurity is imperative so that effective strategies could be developed and implemented.     

Food insecurity is associated with dietary intake and body size of Korean children from low-income families in urban areas

OBJECTIVE: This study examined household food insecurity of urban low-income families in Korea and the associations of the food insecurity with children's dietary intake and body size. DESIGN: Cross-sectional study. SETTING: Low-income neighborhoods in large cities. SUBJECTS: Included 370 children aged 4-12 y, who had all records on dietary intake and anthropometry as well as household food insecurity measures. RESULTS: Using the 10-item Radimer/Cornell Scale, 62.7% of the households showed some degree of food insecurity (8.6% for food insecure for family, 28.4% for food insecure for adults and 25.7% for child hunger households). Food insecurity was linearly and negatively associated with household economic conditions as well as the caretaker's use of nutrition knowledge. There were also significant associations of food insecurity with the children's dietary intakes, indicating the largest amount of nutrients for the children from the household food insecure, followed by those from the food secure, adult food insecure and child hunger groups. The household food insecure children were fatter than the food secure children. The fatter condition of the former children appeared to be related to more frequent intakes of low-quality foods. CONCLUSION: This study reports curvilinear associations between the status of household food insecurity and children's food intakes and fatness. SPONSORSHIP: This work was funded by a grant of the 2001 Korea Health Promotion Research Program, the Ministry of Health & Welfare, Republic of Korea.