Food insecurity and dietary quality in US adults and children: a systematic review
Open accessAbstract
Background Food insecurity is adversely associated with the physical and mental health of adults and children, and the mechanism that underlies this association has been assumed to be dietary intake of lower quality in food insecure than food secure individuals. A thorough understanding of observed associations between food insecurity and dietary quality is needed to test this assumption and may highlight pathways through which to improve the health of food-insecure adults and children.Objective We systematically reviewed all evidence of associations between food insecurity and dietary quality and contrasted associations observed in adults and those for children.Design Evidence came from studies that appeared in indexed, peer-reviewed journals and 1) sampled US residents, 2) separately sampled children and adults, 3) contained a measure of food insecurity or food insufficiency, and 4) included at least one measure of dietary quality.Results In adults, 170 associations between food insecurity and dietary quality were tested, and 50 associations (29%) suggested an adverse association. Food-insecure adults consumed fewer vegetables, fruit, and dairy products than did food secure adults and had lower intake of vitamins A and B-6, calcium, magnesium, and zinc. In children, 130 associations were tested, and 21 associations (16%) showed an adverse association. There was substantial evidence of only lower fruit consumption in food-insecure compared with food-secure children. Reporting and publication biases may have contributed to an overestimation of the association between food insecurity and dietary quality.Conclusions Food insecurity is adversely associated with dietary quality in adults, particularly intakes of nutrient-rich vegetables, fruit, and dairy that promote good health. However, food insecurity was less-consistently associated with lower dietary quality in children. The idea that parents effectively shield their children from compromised dietary quality because of food shortages is supported by the evidence.
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Prior evidence has shown that household-level food insecurity does not correlate with child-level food insecurity.
“Finally, prior evidence has shown that household-level food insecurity does not correlate with child-level food insecurity [36].”
From Material Hardship and Stress from COVID-19 in Immigrant Chinese American Families with Infants (2022) · cites this paper as [36]
The Discussion reports poor agreement between adult and adolescent reports of the adolescent’s own food security, not a lack of correlation between household-level and child-level food insecurity. The Results distinguish household and child measures but do not report their correlation. Searches for that relationship found no passage addressing it. (LLM, conf=0.76)
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Using syndemic theory to understand food insecurity and diet-related chronic diseases
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Food Insecurity Is Associated with Lower Cognitive Functioning in a National Sample of Older Adults
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Food Insecurity, Malnutrition, and the Microbiome
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The Association between Food Security and Store-Specific and Overall Food Shopping Behaviors
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Food insecurity screening: A missing piece in cancer management
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Cardiovascular Health Among Rural and Urban US Adults—Healthcare, Lifestyle, and Social Factors
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Relationship of food insecurity to women’s dietary outcomes: a systematic review
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Food Insecurity and Cognitive Function in Middle to Older Adulthood: A Systematic Review
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Food Insecurity and Cardiovascular Disease Risk Factors among Mississippi Adults
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Factors related to poor diet quality in food insecure populations.
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Perceived and geographic food access and food security status among households with children
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Pathways by Which Food Insecurity Is Associated With Atherosclerotic Cardiovascular Disease Risk
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Food Insecure College Students and Objective Measurements of Their Unused Meal Plans
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- Authors
- Hanson, K. L., & Connor, L. M.
- Affiliations
- Cornell University (US)
- ORCID
- Hanson, Karla L
- Venue
- The American Journal of Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2014-08
- Volume
- 100
- Issue
- 2
- Pages
- 684-692
- ISSN
- 0002-9165 (ISSN-L)
- OpenAlex
- W2079925881
- Cited by
- 660
- References
- 54
- Citations by year
- 2026: 58 · 2025: 62 · 2024: 77 · 2023: 84 · 2022: 84 · 2021: 94 · 2020: 66 · 2019: 55 · 2018: 37 · 2017: 16 · 2016: 15 · 2015: 11 · 2013: 1
- FWCI
- 2.40
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- American Journal of Clinical Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › General Health Professions › Food Security and Health in Diverse Populations
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Keywords
- food insecurity, diet quality, food insufficiency, children, adults, fruit consumption, vegetable consumption, dairy consumption, nutrient intake, publication bias, health disparities
- MeSH terms
- Adult, Child, Child Nutritional Physiological Phenomena, Dairy Products, Diet, Family Characteristics, Female, Food Supply, Fruit, Health Promotion, Humans, Male, Nutritive Value, Patient Compliance, Socioeconomic Factors, Vegetables, Nutrition Policy
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