Cited by 660Food Security and Health in Diverse PopulationsNutritional Studies and DietObesity, Physical Activity, Diet

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Food insecurity and dietary quality in US adults and children: a systematic review

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Hanson, Karla L, Connor, Leah M·2014·The American Journal of Clinical Nutrition

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Abstract

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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Parent attitudes and behaviors associated with household food security among rural lower income familiesPreprint
Moore, A. M., Savage, J. S., Poulsen, M. N., Hosterman, J. F., McCabe, C. F., & Bailey-Davis, L. D. (2024) · medRxiv · doi:10.1101/2024.08.22.24312452
Food Insecurity
Leung, C. W., & Wolfson, J. A. (2024) · doi:10.1093/oso/9780190671051.003.0056
Food insecurity and the consumption of plant-centered meals and high sodium foods among students at three large state universities
Chatmon, J., Kuo, T., Plunkett, S. W., Besnilian, A., & Robles, B. (2024) · Journal of American College Health · doi:10.1080/07448481.2024.2400568
“56 However, many of these studies were conducted among general populations of adults and/or children in the U.S. 54,56 or outside of it, 55 and not exclusively among university students as a target population.”
Influential
Food Insecurity and Safety Net
Mulgrave, V., Mowatt, G., Harmer, S., Glave, S., Hodge, C., & Carlotta, M. (2024) · Food and health · doi:10.1007/978-3-031-63673-8_4
Incentivizing Youth and Family SNAP-Ed Participation With Fruit and Vegetable Rewards
Moffitt, A. J., Thapa, R., Uwashimimana, M. A., & Savaiano, D. A. (2024) · Nutrition Today · doi:10.1097/nt.0000000000000709
Food Security and Cardio-Metabolic Risk in Individuals with Metabolic Syndrome
Nguyen, B., Lohse, B., Powell, L. H., Masters, K. S., Berkley‐Patton, J., & Drees, B. M. (2024) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph22010028 · Cited by 2
Full Issue, Volume 12, Number 3
Peterson, D. J., Cummings, S. R., & North, E. G. (2025) · Journal of Human Sciences and Extension · doi:10.55533/2325-5226.1572
Examining the Impact of Dietary Patterns on Risk of Chronic Disease Among Kentuckians: A Socio-Ecological Review
Teets, C. (2025) · Journal of the Kentucky Academy of Science · doi:10.3101/kyac-85-01-07
Connecting farms to food recovery: perceptions, barriers, and incentives of small farm operators in North Carolina
Fratarcangeli, A., Stroud, B. J., Binger, M., & Sastre, L. R. (2025) · Journal of Hunger & Environmental Nutrition · doi:10.1080/19320248.2025.2480333
Choosing between health and hunger: a qualitative study of medicaid expansion’s role in food security
Terhaar, A., Barnidge, E. K., & Bednarek, H. L. (2025) · Journal of Hunger & Environmental Nutrition · doi:10.1080/19320248.2025.2486269
Implementing a screening protocol for food insecure patients within a long‐term acute care hospital (LTACH): A community health needs assessment (CHNA)
MacDonald, M., Stimson, C. E., Samsel, M., & Gross, T. M. (2025) · Nutrition in Clinical Practice · doi:10.1002/ncp.11292
Food insecurity as a risk factor for suicidal behavior among school-aged children (literature review)
Rothschild-Varibrus, V. Z., Savina, M. V., & Fritzsche, L. (2025) · Psychiatry Neurology and Medical Psychology · doi:10.26565/2312-5675-2025-27-04
Is the Impact of Food Insecurity on Food-Related Behavior Moderated by Generation in South Korea?
Jung, H. S., Hwang, Y. H., & Yoon, H. H. (2025) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph22050766
“In addition, many people without food shortages overly rely on processed or energy-dense foods due to their limited food budgets [24,25].”
Socio-Demographic Risk Factors for Food Insecurity Among Students at Five North Carolina Universities and Colleges: The Influence on Fruit and Vegetable Intake and Perceived Health and Well-BeingPreprint
Hege, A., Wall-Bassett, E., Babatunde, T., Farris, A. R., Nunnery, D. L., Berner, M. M., Soldavini, J., Hege, A. S., & Hagedorn, R. L. (2025) · SSRN Electronic Journal · doi:10.2139/ssrn.5249902
Diet Quality and the Elusive Pursuit of SDG Target 2.1: Lessons from Argentina
Maldonado, M. A., & Almstedt, H. C. (2025) · Springer eBooks · doi:10.1007/978-3-031-83841-5_6
The influence of socioeconomic factors and apolipoprotein ε genotype on cognitive outcomes in a multi-ethnic sample living with HCV and HIV
Burke, S. L., Grudzien, A., Li, T., Garcia, S. J., Martínez, S. S., Jurich, E., Jimenez, D. R., Hernández, J., Liu, Q., Tyrell, T. A., et al. (2025) · International Journal of STD & AIDS · doi:10.1177/09564624251324968
“71,72 In high-income countries, food in-security has been linked to a higher body mass index (BMI).”
“We didn’t turn away people”: Perspectives of key informants at stakeholder agencies in San Diego County, CA in meeting the food insecurity demands during the COVID-19 pandemic
Smith, C. E., Enns, K., Molina, T., Doolan, E. B., & McClain, A. C. (2025) · Translational Behavioral Medicine · doi:10.1093/tbm/ibaf016
“FI has been associated with various negative nutrition and health outcomes, such as decreased nutrient intake, increased body mass index, and increased risk of cardiometabolic conditions, mental health conditions such as depression and anxiety, and all-cause death [3–6].”
Kids to the Front: Exploring Children's Food Practice Perspectives for a Child-Centred Approach
Wright-Pedersen, S. (2025) · QUT ePrints (Queensland University of Technology) · doi:10.5204/thesis.eprints.257642
Trends in Breast Cancer Screening Between Medicare Beneficiaries With and Without Food Insecurity
Kim, Y., Kim, J., Park, S., Heflin, C. M., Kim, H., & Li, Y. (2025) · AJPM Focus · doi:10.1016/j.focus.2025.100386
Implementing and evaluating a fresh produce utilization tracking system in a New England non-profit food security hub
Mitchell, L., & Picardy, J. (2025) · Journal of Hunger & Environmental Nutrition · doi:10.1080/19320248.2025.2535613
Food Insecurity and Appetitive Traits: A Prospective Analysis in Generation XXI Cohort
Costa, A., Hetherington, M. M., & Oliveira, A. (2025) · International Journal of Eating Disorders · doi:10.1002/eat.24530
Food as Medicine in Hidradenitis Suppurativa: A Review of Dietary Effects on Hidradenitis Suppurativa Pathogenesis
Lam, T., Gruzmark, F. S., Ondreyka, J., Lenczowski, J., Harris-Tryon, T. A., Frew, J. W., & Lev‐Tov, H. A. (2025) · Integrative and Complementary Therapies · doi:10.1177/27683192251376656
Evaluation of the Feasibility and Construct Validity of a Novel Method to Measure Household Fruit and Vegetable Procurement in Low-Income Community Settings
Horning, M. L., Gorman, K. S., Steiner, J., Wolfson, J. A., Hu, J., Laska, M. N., Fulkerson, J. A., & Harnack, L. (2025) · Journal of the Academy of Nutrition and Dietetics · doi:10.1016/j.jand.2025.10.011
Food Insecurity was Associated With Poorer Sleep Quality and Increased Stress Among Dental Students at a HBCU and a Predominantly White School
Laurence, B., Marshall, T. A., Qian, F., Robinson‐Warner, G., Kumar, A., Handoo, N., & Anderson, C. L. (2025) · Journal of Dental Education · doi:10.1002/jdd.70067
Study of the Dietary Intake in Multiple Child Families: A Multi-Level Analysis of Energy and Nutrient Intake and the Food Set Structure
An, M., Baturin, A. K., Арсеньевна, М. Э., & Nikityuk, D. B. (2025) · ЗДОРОВЬЕ НАСЕЛЕНИЯ И СРЕДА ОБИТАНИЯ - ЗНиСО / PUBLIC HEALTH AND LIFE ENVIRONMENT · doi:10.35627/2219-5238/2025-33-9-67-77
Multidimensional dietary patterns and their joint associations with intersecting sociodemographic characteristics among adults in Canada: a cross-sectional study
Hutchinson, J. M., Spicker, D., Lamarche, B., Wallace, M., Côté, M., Espin, A. T., & Kirkpatrick, S. I. (2025) · Applied Physiology Nutrition and Metabolism · doi:10.1139/apnm-2025-0045
Food Insecurity, Diet Quality and Associated Factors among Mothers and Children in Rural North-East GhanaPreprint
Awuuh, V. A., Apprey, C., & Annan, R. A. (2025) · medRxiv · doi:10.1101/2025.11.17.25340374

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)
DOI: 10.3945/ajcn.114.084525
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
FWCI: 2.40
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/open-access/userlicense/1.0/ (vor, 3122 d)
Locations: American Journal of Clinical Nutrition (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › 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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Food insecurity and dietary quality in US adults and children: a systematic review

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