1. Introduction
Despite increased access to resources and economic advantages, approximately 10% of people living in high-income countries (HIC) experience food insecurity, with factors relating to food insecurity varying by level of development and Gross Domestic Product per capita [1]. After controlling for economic factors, some household characteristics can increase the risk of experiencing food insecurity. Households are more likely to experience food insecurity if they include single women with children [2], ethnic minority populations [2], households with grandchildren present [3], households with a disabled parent or child [4], households with someone who is currently or previously incarcerated [5] and households with an adult smoker [6].
Food insecurity can affect all stages of the lifespan; however, women are at high risk of becoming food insecure due to entrenched societal power inequality and a range of socio-economic conditions such as domestic violence, poor employment, and education [7,8]. Households with children are at increased risk of food insecurity, as such, mothers and in particular single mothers experience a higher rate of food insecurity compared with women without children [7]. Living in a food insecure household during pregnancy may increase risk of greater gestational weight gain, disordered eating, chronic disease and pregnancy complications [9] while the impact of food insecurity on young children is particularly concerning given they are at a key stage of growth and development which can influence health during adolescence and even adulthood [10]. Infants residing in food insecure households are more likely to have poor health, be nutrient deficient and be hospitalized [11,12] with poor health and developmental challenges, including cognitive, linguistic, social, and emotional challenges being more common among food insecure children [13]. While there are clear negative health outcomes for food insecure households with pregnant women and young children, the coping mechanisms employed by these households are not well understood. Studies have reported that mothers experiencing food insecurity are likely to engage in coping strategies such as delaying payments of bills, giving up services, selling or pawning possessions and diluting infant formula [14,15].
Globally, there is a commitment to improve maternal and child nutrition across countries through the 2030 Sustainable Development Goals. Understanding factors that threaten pregnant women and caregivers of young children’s food supply and nutritional adequacy is fundamental to supporting both the short- and long-term health of women and children. It is important to understand food insecurity in this population as the problem is widespread and impacts women and children in HIC as well as low–medium income countries. Collectively, in HIC, evidence which best summarises factors associated with food insecurity is lacking. Furthermore, factors associated with food insecurity in HIC may be different from those associated with food insecurity in low–medium income countries. Identifying such factors is essential to understand and inform how and when strategies may be implemented which specifically target food insecurity in this population group.
Existing literature reviews have summarized the factors that influence food insecurity in the general population, as well as outcomes potentiated by the experience of food insecurity. Many reviews have focused specifically on the United States (US) and have examined the factors influencing food insecurity, including food distribution, coping mechanisms (such as trade-offs between buying food and other expenses), the intersection of food insecurity and obesity [16,17,18] and chronic disease and health outcomes [10,19]. Literature reviews have focused on the experience of food insecurity among households with children [20] but have not been specific to pregnant women and households with young children under the age of 6. Reviews that explore the food security situation across more than one country include rates of food insecurity in post-secondary education campuses [21], food insecurity measurement tools utilized in HIC [22] and the impact of local environmental characteristics on food insecurity, including social capital, crime, and access to food stores [23]. Despite these reviews spanning geographies and topics, the factors associated with food insecurity among pregnant women and caregivers of young children in HICs are not well understood. As scoping reviews are useful tools to scope a body of literature, identify knowledge gaps and key characteristics or factors related to a concept [24], this review seeks to uncover the factors associated with food insecurity in this population. The aim of this scoping review is to identify the factors that influence food insecurity among pregnant women and caregivers of young children living in HIC.
2. Materials and Methods
This scoping review was conducted to investigate the factors that influence food insecurity among pregnant women and households with young children (aged 0–6 years) in HICs. A comprehensive systematic search informed by Peters et al. [25] was conducted in four databases: Medline complete, Embase, Global Health, and CINAHL. These databases were chosen to provide coverage of public health nutrition and nursing and allied health literature in HIC including the US and Europe. Search terms (Appendix A, Table A1) were relevant to: food insecurity, determinants, pregnancy and family, and HIC as defined by the Human Development Index as having a higher life expectancy, education and per capita income indicators [26]. The search strategy involved combining the search terms and all terms were searched in title and/or abstract. To ensure inclusion of recent literature the search was limited to the last 15 years (date range: 1 January 2005 to 1 April 2020) and articles published in English. The search was conducted on 21 April 2020.
References were imported into Covidence [27] to manage the screening process. To determine inclusion, two phases of screening were conducted. Firstly, two reviewers independently screened the titles and abstracts for inclusion. This was followed by full-text screening to remove irrelevant articles based on the exclusion criteria. Any conflicts were resolved by a third reviewer. Table 1 outlines the inclusion and exclusion criteria, developed using the PICO/PICo frameworks, in terms of population (pregnant women and care givers with children aged 0–6), outcome (food security) and context (HIC) [28]. Articles were excluded if for example they included the wrong population group [29], were systematic or systematic-like reviews [30], or did not explicitly mention food insecurity among the target population group [31]. Full-text articles were read, and relevant information was extracted using predetermined categories including country of study, setting/population, study design, food insecurity measurement tool used and outcomes. Consistent with the approach taken in scoping reviews, articles were not accessed for quality, rather the various factors related to food security were extracted [24]. The range of factors were discussed by the research team and grouped into a series of overarching constructs. Results were summarised and organised into these key constructs that influence food security and insecurity. The research team reviewed and discussed the extracted data and results to ensure consistency across reviewers.
3. Results
The initial search resulted in 1418 articles, of which 716 were duplicates. The title and abstract of the remaining 657 articles were read; 495 were excluded as they did not meet the inclusion criteria. The full text of the remaining 164 studies were read with a further 133 excluded as they did not meet inclusion criteria. Reasons for exclusion included wrong population group, study design or outcomes as outlined in Table 1. A total of 29 relevant studies were included for analysis (Figure 1). Most studies were conducted in the US (n = 20), with the remaining from Canada (n = 3), Malaysia (n = 2), Argentina (n = 2), Mexico and US (n = 1), and New Zealand (n = 1). Most studies employed a cross-sectional design (n = 22) and just over half were secondary data analysis of existing population data sets (n = 16), while three studies employed qualitative methodology. A majority of studies (n = 20) used a version of the United States Department of Agriculture (USDA) Food Security Module to measure food security status, with the Radimer/Cornell hunger scale being the second most commonly used measure (n = 4). One of the studies included pregnant women only, none of the studies focused on single caregivers specifically. Details of the 29 included studies can be found in Appendix B, Table A2.
Analysis revealed 13 constructs relating to factors associated with food security. Table 2 lists these constructs and identifies the factors as positively associated with food security (+) or inversely associated with food security (−).
The main findings of this scoping review are organised into 13 constructs as outlined in Table 2. Sociodemographic factors were included in 17 of the 29 articles. These factors include income and employment [32,33,34,35,36,37,38,39,40,41,42,43,44], education [35,37,40,41,45,46,47], ethnicity [33,36,37,39,46,48] and family composition [41,43,46,47] as the main factors associated with food insecurity for pregnant women and caregivers of young children.
Coping strategies were mentioned in eight papers [32,34,35,36,43,45,49,50]. Coping strategies include utilising social support and making trade-offs about what to eat, who eats and how often meals are eaten. These behaviours are associated with an increased likelihood of food insecurity but also as a mechanism to protect against food insecurity. Maternal depression and mental health were also established in eight papers [36,42,46,47,48,49,51,52]. Maternal depression was associated with increased likelihood of food insecurity [46,53] but also, as a health outcome associated with the stress and anxiety of food insecurity [42,48]. Parenting stress included lack of time and social support and feelings of isolation, all of which may be barriers to food security for some families [49]. In addition, Patel and Surkin (2016) found children born to parents who jointly reported unplanned childbearing were more likely to be exposed to household food insecurity in their first two years of life, independent of other factors.
Residence stability and crowding were included in seven papers associated with increased rates of food insecurity [34,39,40,43,45,46,54]. Parent acculturation, which includes length of time spent living in the country of study and immigrant status, were a focus of six studies [35,46,55,56,57,58]. Interestingly, one paper found length of time living in the country of study was not associated with household food insecurity [55] while the other five papers did find an association. Hadley and Sellen (2006) highlight how a more recent arrival in the US is associated with difficulty shopping and preparing food in a foreign environment, both of which can increase food insecurity. In addition, immigrant status is linked to employment options and access to welfare benefits and food assistance programs, thus impacting food security. Six papers described how participation in government food assistance programs and/or charitable feeding program use is associated with food insecurity [35,36,48,50,59,60], however, only two found this to be protective against food insecurity [36,59]. Six papers mentioned diet quality, three highlighted how food insecurity was associated with reduced intakes of high-cost nutrient-rich foods and increased intake of low-cost nutrient-poor foods for both caregivers [55] and young children [38,39], two report an association between food insecurity and poor iron status in pregnant women [37] and young children [40] and one paper reports an association between food insecurity and reduced food variety [35]. Having a member of the household who was a smoker [37,39,45,47], who was a frequent user of health care [33] or who did not have health care coverage [37] placed additional financial strain on families and were found to negatively impact food security status as households prioritise spending money on other necessities over food [49,50]. Local neighbourhood infrastructure and characteristics [32], along with general access to food stores, and healthy affordable food stores specifically [32], emerged as other factors associated with food security from the literature.
4. Discussion
To our knowledge this is the first review that identifies a broad set of factors associated with food insecurity among pregnant women and caregivers of young children and group these findings into clear constructs. A total of 13 constructs relating to factors associated with food insecurity arose from the literature.
The literature included in this review covered a range of known risk factors for food insecurity including economic, social, and health. Economic factors including income and employment predict the financial resources of a household to purchase food and was the most frequently mentioned construct, with 13 papers highlighting a link between income-poverty and food insecurity. This is consistent with data from national surveys in the US which have routinely shown household income to be the strongest predictor of risk of food insecurity [61]. In other HIC, such as Australia, the average weekly full-time wage for women is 15.3% lower than for men, with women more likely to be employed part-time [62], thus reducing their earning capacity and placing them at risk of poverty. Lower income means a reprioritization of funds, food is replaced by accommodation costs, utility bills and other expenses [14]. Policy responses for food security need to address the underlying issue of inadequate income and available money to spend on food for women living in HICs.
Known social risk factors contributing to food insecurity include ethnicity, education level, marital status, family size and acculturation. These were all identified as common factors associated with food insecurity in households with pregnant women and/or young children and highlight the complexity in delivering relief strategies which might be useful in reducing food insecurity in this population group across HICs. For example, immigrating to a new country and the length of time spent living in that country not only impacts income and employment opportunities, but also knowledge of how to access welfare services and difficulties with shopping and food preparation in a foreign environment. Immigrant pregnant women/caregivers may need additional support to overcome barriers to nutritional adequacy and access to culturally appropriate foods. Social factors that are likely to be unique to this population group uncovered in this review include maternal depression, parenting stress, lack of time and social support, and feelings of isolation. Unplanned childbearing and its association to food insecurity was also a finding unique to this population group. Strategies to better support caregivers of young children and provide opportunities for them to socially connect could help alleviate some of these factors.
Poorer dietary and nutritional intakes are associated with diet-related chronic conditions such as diabetes and obesity [18], and elevated poor mental health including depression and anxiety [63]. Reduced intakes of high-cost nutrient-rich foods and increased intake of low-cost nutrient-poor foods have been observed for both caregivers and children [38,39,55] along with poor iron status in pregnant women and children [37,40]. Considering the fundamental and crucial role of adequate nutrition in supporting optimal pregnancy outcomes as well as optimal growth and development of children during the early years of life, it is essential that food insecurity is a key priority of public health programs supporting maternal and child health.
Studies among children suggest that they can recognise and experience the stress of food insecurity and that childhood experiences of hunger may be associated with poor physical and mental health outcomes into late adolescence [64]. This is consistent with the theory that the lived experience of food insecurity during critical periods of child development results in poor health outcomes later in life [10]. This highlights the importance of exploring factors associated with food insecurity during pregnancy and for families with young children, given that many adverse health, growth and development outcomes in early childhood development are well-known to track beyond childhood and into adverse health outcomes later in life [65].
The lack of literature on lived experience of household food insecurity in pregnant women and families with young children was evident in this scoping review. Only three of the 29 studies used a qualitative methodology to describe and understand the lived experience. Qualitative research methods enable researchers to delve into questions of meaning, examine institutional and social practices and processes, identify barriers and facilitators to change and discover the reasons for the success or failure of interventions [66]. Further qualitative studies on the lived experience of household food insecurity in pregnant women and families with young children could aid important understanding of the many complex factors associated with and resulting from food insecurity and offer insight into potential food security programs, policies and economic or social attributes required to improve food security for this population.
Just over half of the studies included in this review were based on secondary analysis of existing national data sets as opposed to primary research. Furthermore, the national data sets used for secondary analysis were used in multiple papers and are dated. For example, the Children’s Healthwatch (1998–2005) was used as the data set in four of the papers and these data are now over fifteen years old which raises questions around the applicability of the findings to the current context. A majority of the studies (70%) were conducted in the US with only five of the other 62 HIC represented in this review (Canada, Malaysia, Argentina, Mexico, and New Zealand). This is a research gap that needs to be urgently filled to increase understanding of factors contributing to food insecurity across families in other countries, contexts and among diverse cultural groups if the issue is to be tackled globally.
While there are a number of strengths to this review, including the identification of the 13 constructs, there are several limitations. One limitation is the majority of the studies included were conducted in the US. This may be related to the English inclusion criteria. While many countries use English, there is some research that may have been missed. One impact of this is that while all HIC were included in the search given that the majority of the research is from the US may mean the results are skewed to the US context. Future research could explore how the identified constructs changed if only US literature was examined versus including literature from other countries. Given the vast experiences between the HIC included in this search, it would be prudent for researchers to draw in research in other languages and for researchers in HIC outside of the US to continue to explore issues related to food insecurity among this population, as this will provide a fuller picture of the current experience. Furthermore, as scoping reviews do not attempt to appraise the quality of evidence, the constructs found within the literature should be interpreted with caution. Despite these limitations, this review identified a range of factors that influence food insecurity among pregnant women and households with young children that could be useful in future measurement, screening and strategies, and could be translated across a range of geographical contexts.
5. Conclusions
From this scoping review we have found a broad range of factors that have been grouped into 13 constructs associated with food insecurity that could be useful in measuring and understanding food insecurity in pregnant women and families with young children. Currently, the commonly used monitoring frameworks in HIC, may be too narrow. Capturing known economic, health and social risk factors such as recent job loss, maternal mental health and depression and family composition could be useful in screening families with young children and pregnant women at risk of food insecurity and planning and delivering appropriate policies and programs.
A.B., C.P., F.H.M., K.S., P.v.d.P. and S.A.M. contributed to the development of the study design, manuscript development and revision. A.Y. and R.L. established the research team, provided guidance on study design and manuscript revision. All authors have read and agreed to the published version of the manuscript.
Not applicable.
Not applicable.
Not applicable.
The authors declare no conflict of interest.
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Inclusion and exclusion criteria used for abstract and full-text screening.
| Inclusion Criteria | Exclusion Criteria |
|---|---|
|
|
Summary of constructs associated with food security arising from the literature.
| Food Security Construct | No. of Papers | Details of Factors Associated with Food Security |
|---|---|---|
| Income and employment | 13 | Low income -, job loss - and payment schedules -, income support -, caregiver unemployment -, poverty -, not receiving welfare -, low social economic status - (combined score of education, occupation and household income), living below poverty line -, mothers as housewives - |
| Coping strategies | 8 | Stretching food+ -, going without+ -, caregivers/children skip meals or cut back on variety of foods consumed+ -, going to bed hungry+ -, other household members going hungry+ -, reducing the number of meals each day+ -, cooking whatever is available+ -, buying cheaper food+ -, shopping at value stores+ -, using coupons+ -, going to many locations to find best price+ -, reducing money spent on children’s education+ -, borrowing money+ -, social support and social cohesion+, contact with extended family and participation in food sharing networks+ -, consumption of meals outside the home (at other people’s homes)+ -, turning to family and friends+ -, receiving food from others+ - |
| Maternal depression/mental health | 8 | Maternal depression and poor health status -, parenting stress -, lack of time -, lack of social support -, feelings of isolation -, unwanted child-bearing - |
| Residence stability and crowding | 7 | Housing and energy insecurity -, experience greater number of moves -, receiving housing subsidy -, do not own any land -, household crowding -, living in households with five or more members -, crowding in homes in need of major repair - |
| Education | 7 | Caregivers/mothers with lower levels of education - |
| Parent acculturation | 6 | Immigrant status -, length of time in country+ -, difficulty with shopping and food preparation in a foreign environment - |
| Ethnicity | 6 | Ethnicity+ -, race+ -, ethnic minority - |
| Participation in food assistance programs | 6 | Participation in SNAP+ -, participation in WIC + -, food stamp usage -, reliance on school meals - |
| Diet Quality | 6 | Reduced consumption of high cost and micronutrient rich foods -, increased consumption of low-cost traditional staple foods -, iron status -, food variety - |
| Family composition | 4 | Caregivers’ marital status (single/widowed/separated/divorced) -, larger household size, larger number of children - |
| Smoking | 4 | Living in a house with a smoker -, maternal smoking -, mother smoking during pregnancy - |
| Food access and availability | 4 | Economic constraints - and food pricing (including cost of fruit and vegetables) -, choosing between food and other necessities (including medicine and bills) -, lack of access to healthy food - or food stores in general - |
| Health care | 2 | Health care usage -, lack of health insurance coverage - |
| Other | 2 | Lack of urban infrastructure - and exposure to environmental contaminants - |
+ Positively associated with food security; - Inversely associated with food security.
Appendix A
Search terms.
| Food Security | Determinants | Pregnancy and Families with Children Aged 0–6 Years | High-Income Countries |
|---|---|---|---|
| “food securit *” OR “food insecurit *” OR |
“factor” OR |
“child *” OR |
“andorra” OR “argentina” OR “australia” OR “austria” OR “bahamas” OR “bahrain” OR “barbados” OR “belarus” OR “belgium” OR “brunei darussalam” OR “bulgaria” OR “canada” OR “chile” OR “croatia” OR “cyprus” OR “czech republic” OR “denmark” OR “estonia” OR “france” OR “finland” OR “germany” OR “greece” OR “hong kong” OR “hungary” OR “iceland” OR “ireland” OR “israel” OR “italy” OR “japan” OR “kazakstan” OR “korea” OR “kuwait” OR “latvia” OR “liechtenstein” OR “lithuania” OR “luxembourg” OR “malta” OR “malaysia” OR “montenegro” OR “netherlands” OR “new zealand” OR “norway” OR “oman” OR “palau” OR “poland” OR “portugal” OR “qatar” OR “romania” OR “russia” OR “saudi arabia” OR “seychelles” OR “singapore” OR “slovakia” OR “slovenia” OR “spain” OR “sweden” OR “switzerland” OR “turkey” OR “united arab emirates” OR “united kingdom” OR “united states” OR “uruguay” |
* used for word truncation.
Appendix B
Studies included in review.
| Author | Year | Country | Setting/ |
MCH Population | n | Primary or Secondary Analysis of Dataset Named (Year Conducted) | Study Design | FI Tool | Food Security Construct(s) |
|---|---|---|---|---|---|---|---|---|---|
| Alderete et al. | 2018 | Argentina | Food insecure participants of MCH programs in Primary Health Care clinics | Mothers of children < 1–6 years | n = 11 | Primary (2015) | Qualitative | USDA HHFSM | Income and Employment |
| Anderson et al. | 2014 | USA | Recently arrived Sudense refugees | Caregivers of children 0–3 years | n = 49 | Primary (2002) | Cross-sectional | Radimer/Cornell Hunger Scale | Parent Acculturation |
| Cheu et al. | 2020 | USA | Women receiving prenatal care in a Chicago hospital | Postpartum women | n = 299 | Primary (2018) | Cross-sectional | USDA HHFSM | Income and Employment |
| Chilton et al. | 2009 | USA | Immigrants and non-immigrants ED and pediatric care clinic users in 7 large cities | Mothers of children 0–3 years | n = 19,275 | Children’s Sentinel Nutrition Assessment Program (1998–2005) | Cross-sectional | USDA HHFSM | Parent Acculturation |
| Cook et al. | 2013 | USA | Caregivers visiting primary/acute care clinics and EDs in 7 large cities | Caregivers of children 0–2 years | n = 41,515 | Children’s Health Watch Survey (1998–2011) | Cross-sectional | USDA HHFSM | Family Composition |
| Egeland et al. | 2010 | Canada | 16 Nunavut Inuit communities | Caregivers of children 3–5 years | n = 388 | Primary (2007–2008) | Cross-sectional | USDA HHFSM | Income and Employment |
| Findlay et al. | 2013 | Canada | Children identifying as Inuit | Caregivers of children 2–5 years | n = 1234 | Aboriginal Children’s Survey (2006) | Cross-sectional | Single item | Education |
| Garg et al. | 2015 | USA | Nationally representative sample of children | Mothers of children at 9 & 24 months | n = 2917 | Early Childhood Longitudinal Study, Birth Cohort (2001–2007) | Longitudinal | USDA HHFSM | Ethnicity |
| Hadley & Sellen | 2006 | USA | Recently arrived Liberian refugees | Caregivers of children 0–5 years | n = 33 | Primary (unknown) | Cross-sectional | Radimer/Cornell Hunger Scale | Income and Employment |
| King | 2017 | USA | National sample of children, oversampling families in which mothers were unmarried at the birth of their child | Mothers of children at ages 3 & 5 years | n = 2481 | Fragile Families and Child Wellbeing Study (1998–2000) | Longitudinal | USDA HHFSM | Income and Employment |
| King | 2018 | USA | National sample of children, oversampling families in which mothers were unmarried at the birth of their child | Mothers of children at ages 3 & 5 years | n = 2044 | Fragile Families and Child Wellbeing Study (1998–2000) | Longitudinal | USDA HHFSM | Family Composition |
| Kreider et al. | 2016 | USA | National sample of adults and children in which vulnerable groups are oversampled | Mothers and children 0–5 years | n = 4614 | National Health and Nutrition Examination Survey (1999–2008) | Cross-sectional | USDA HHFSM | Participation in Food Assistance Programs |
| Lindsay et al. | 2009 | USA | Immigrant, low-income Latina mothers | Mothers of children 0–48 months | n = 51 | Primary (2005–2006) | Qualitative | None | Coping Strategies |
| Lindsay et al. | 2012 | Argentina | Mothers with children attending child health and nutrition services | Mothers of children 2–5 years | n = 38 | Primary (2006) | Qualitative | None | Coping Strategies |
| Meyers et al. | 2005 | USA | Caregivers visiting pediatric clinics and EDs in 6 large cities | Caregivers of children 0–3 years | n = 11,723 | Children’s Sentinel Nutrition Assessment Program (1998–2003) | Cross-sectional | USDA HHFSM | Health Status |
| Morrissey et al. | 2014 | USA | Nationally representative sample of children | Caregivers of children at 9 months, 24 months, 4 years, and kindergarten entry | n = 11,700 | Early Childhood Longitudinal Study, Birth Cohort (2001–2007) and data from the Council for Community and Economic Research (2001–2007) | Cross-sectional | USDA HHFSM | Food Access and Availability |
| Neault et al. | 2007 | USA | Immigrant mothers visiting pediatric clinics or EDs in 6 large cities | Mothers of children 0–12 months | n~3592 |
Children’s Sentinel Nutrition Assessment Program (1999–2004) | Cross-sectional | USDA HHFSM | Parent Acculturation |
| Park | 2014 | USA | National sample of adults and children in which vulnerable groups are oversampled | Pregnant women | n = 1045 | National Health and Nutrition Examination Survey (1999–2010) | Cross-sectional | USDA HHFSM | Income and Employment |
| Patel & Surkan | 2016 | USA | Nationally representative sample of children | Caregivers of children at ages 9 & 24 months | n = 6150 | Early Childhood Longitudinal Study, Birth Cohort (2001–2007) | Longitudinal | USDA HHFSM | Maternal Depression/Mental Health |
| Rosas et al. | 2009 | USA & Mexico | Mexican-born mothers and their children | Mothers of children 5 years | n = 602 | Primary (2005–2006) | Cross-sectional | USDA HHFSM | Income and Employment |
| Schlichting | 2019 | New Zealand | Nationally representative sample of children | Caregivers of children 9 months | n = 6385 mothers, n = 6467 infants | Growing Up in New Zealand Study (2009–2010) | Cross-sectional (baseline data of a longitudinal survey) | New | Income and Employment |
| Skalicky | 2006 | USA | Caregivers visiting a pediatric ED in Boston | Caregivers of children 0–3 years | n = 626 | Children’s Sentinel Nutrition Assessment Program (1996–2001) & Iron Lab | Cross-sectional | USDA HHFSM | Income and Employment |
| Tang | 2020 | USA | Latina mothers visiting a pediatric ED in Boston | Mothers of children 0–48 months | n = 2145 | Children’s Health Watch Survey (2004–2013) | Cross-sectional | USDA HHFSM | Parent Acculturation |
| Trappmann | 2015 | USA | Caregivers of children attending Head Start in rural communities | Caregivers of children 3–5 years | n = 347 | Primary (2008–2010) | Cross-sectional | Single item | Participation in Food Assistance Programs |
| Ward | 2019 | USA | Female caregivers of children attending Head Start | Female caregivers of children 3–5 years | n = 693 | Primary (2006) | Cross-sectional | USDA HHFSM | Maternal Depression/Mental Health |
| Wong | 2014 | Malaysia | Mothers visiting 1 of 5 maternal and child health clinics in Terengganu | Mothers of children 0–5 years | n = 274 | Primary (2012) | Cross-sectional | Radimer/Cornell Hunger Scale | Income and Employment |
| Wong et al. | 2019 | Canada | Healthy urban children | Mothers of children 0–3 years | n = 3838 | The Applied Research Group for Kids (TARGet Kids!) Longitudinal Cohort (2008–2016) | Cross-sectional | USDA HHFSM (2 item screener) | Income |
| Wu | 2018 | USA | Nationally representative sample of children | Caregivers of children at 9 months, 24 months, 4 years, and kindergarten entry | n = 6970 | Early Childhood Longitudinal Study, Birth Cohort (2001–2006) | Cross-sectional | USDA HHFSM | Income and Employment |
| Zalilah | 2008 | Malaysia | 7 low-income, rural villages | Caregivers of children 1–6 years | n = 200 | Primary (unknown) | Cross-sectional | Radimer/Cornell Hunger Scale | Income and Employment |
References
1. Smith, M.; Rabbitt, M.; Coleman-Jensen, A. Who are the world’s food insecure? New evidence from the Food and Agriculture Organization’s food insecurity experience scale. World Dev.; 2017; 93, pp. 402-4012. [DOI: https://dx.doi.org/10.1016/j.worlddev.2017.01.006]
2. Smith, T.; Bertmann, F.; Pinard, C.; Schober, D.; Shuval, K.; Nguyen, B.; Fricke, H.E.; Yaroch, A. Factors Associated With Supplemental Nutrition Assistance Program Participation Among the Working Poor: Findings From 2012 American Community Survey. J. Hunger. Environ. Nutr.; 2016; 12, pp. 169-180. [DOI: https://dx.doi.org/10.1080/19320248.2016.1146196]
3. Ziliak, J.; Gundersen, C. Multigenerational Families and Food Insecurity. South. Econ. J.; 2016; 4, pp. 1147-1166. [DOI: https://dx.doi.org/10.1002/soej.12082]
4. Sonik, R.; Parish, S.; Ghosh, S.; Igdalsky, L. Food insecurity in US households that include children with disabilities. Except. Child.; 2016; 83, pp. 42-57. [DOI: https://dx.doi.org/10.1177/0014402916651847]
5. Cox, R.; Wallace, S. Identifying the link between food security and incarceration. South. Econ. J.; 2016; 82, pp. 1062-1077. [DOI: https://dx.doi.org/10.1002/soej.12080]
6. Cutler-Triggs, C.; Fryer, G.; Miyoshi, T.; Weitzman, M. Increased rates and severity of child and adult food insecurity in households with adult smokers. Arch. Pediatrics Adolesc. Med.; 2008; 162, pp. 1056-1062. [DOI: https://dx.doi.org/10.1001/archpediatrics.2008.2] [PubMed: https://www.ncbi.nlm.nih.gov/pubmed/18981354]
7. Matheson, J.; McIntyre, L. Women respondents report higher household food insecurity than do men in similar Canadian households. Public Health Nutr.; 2014; 17, pp. 40-48. [DOI: https://dx.doi.org/10.1017/S136898001300116X] [PubMed: https://www.ncbi.nlm.nih.gov/pubmed/23651492]
8. Ricks, J.; Cochran, S.; Arah, O.; Williams, J.; Seeman, T. Food insecurity and intimate partner violence against women: Results from the California Women’s Health Survey. Public Health Nutr.; 2016; 19, pp. 914-923. [DOI: https://dx.doi.org/10.1017/S1368980015001986] [PubMed: https://www.ncbi.nlm.nih.gov/pubmed/26096652]
9. Laraia, B.; Siega-Riz, A.; Gundersen, C. Household food insecurity is associated with self-reported pregravid weight status, gestational weight gain, and pregnancy complications. J. Am. Diet. Assoc.; 2010; 110, pp. 692-701. [DOI: https://dx.doi.org/10.1016/j.jada.2010.02.014]
10. Laraia, B. Food insecurity and chronic disease. Adv. Nutr.; 2013; 4, pp. 203-212. [DOI: https://dx.doi.org/10.3945/an.112.003277] [PubMed: https://www.ncbi.nlm.nih.gov/pubmed/23493536]
11. Cook, J.T.; A Frank, D.; Berkowitz, C.; Black, M.M.; Casey, P.H.; Cutts, D.B.; Meyers, A.F.; Zaldivar, N.; Skalicky, A.; Levenson, S. et al. Food insecurity is associated with adverse health outcomes among human infants and toddlers. J. Nutr.; 2004; 134, pp. 1432-1438. [DOI: https://dx.doi.org/10.1093/jn/134.6.1432] [PubMed: https://www.ncbi.nlm.nih.gov/pubmed/15173408]
12. Park, K.; Kersey, M.; Geppert, J.; Story, M.; Cutts, D.; Himes, J. Household food insecurity is a risk factor for iron-deficiency anaemia in a multi-ethnic, low-income sample of infants and toddlers. Public Health Nutr.; 2009; 12, pp. 2120-2128. [DOI: https://dx.doi.org/10.1017/S1368980009005540] [PubMed: https://www.ncbi.nlm.nih.gov/pubmed/19405987]
13. Rose-Jacobs, R.; Black, M.M.; Casey, P.H.; Cook, J.T.; Cutts, D.B.; Chilton, M.; Heeren, T.; Levenson, S.M.; Meyers, A.F.; Frank, D.A. Household Food Insecurity: Associations With At-Risk Infant and Toddler Development. Pediatrics; 2008; 121, pp. 65-72. [DOI: https://dx.doi.org/10.1542/peds.2006-3717] [PubMed: https://www.ncbi.nlm.nih.gov/pubmed/18166558]
14. Tarasuk, V. Household food insecurity with hunger is associated with women’s food intakes, health and household circumstances. J. Nutr.; 2001; 31, pp. 2670-2676. [DOI: https://dx.doi.org/10.1093/jn/131.10.2670]
15. Burkhardt, M.; Beck, A.; Kahn, R.; Klein, M. Are our babies hungry? Food insecurity among infants in urban clinics. Clin. Pediatrics; 2012; 51, pp. 238-243. [DOI: https://dx.doi.org/10.1177/0009922811426767]
16. Franklin, B.; Jones, A.; Love, D.; Puckett, S.; Macklin, J.; White-Means, S. Exploring Mediators of Food Insecurity and Obesity: A Review of Recent Literature. J. Community Health; 2012; 37, pp. 253-264. [DOI: https://dx.doi.org/10.1007/s10900-011-9420-4]
17. Dinour, L.; Bergen, D.; Yeh, M.-C. The Food Insecurity-Obesity Paradox: A Review of the Literature and the Role Food Stamps May Play. J. Am. Diet. Assoc.; 2007; 107, pp. 1952-1961. [DOI: https://dx.doi.org/10.1016/j.jada.2007.08.006]
18. Larson, N.; Story, M. Food insecurity and weight status among US children and families a reveiw of the literature. Am. J. Prev. Med.; 2011; 40, pp. 166-173. [DOI: https://dx.doi.org/10.1016/j.amepre.2010.10.028]
19. Gundersen, C.; Ziliak, J.P. Food insecurity research in the United States: Where we have been and where we need to go. Appl. Econ. Perspect. Policy; 2018; 40, pp. 119-135. [DOI: https://dx.doi.org/10.1093/aepp/ppx058]
20. Zaçe, D.; Di Pietro, M.; Caprini, F.; Ricciardi, W.; de Waure, C. Prevalence and Correlates of Food Insecurity among Children in High-Income European Countries. A Systematic Review. Ann. Dell’Istituto Super. Sanita; 2022; 56, pp. 90-98.
21. Bruening, M.; Argo, K.; Payne-Sturges, D.; Laska, M. The Struggle Is Real: A Systematic Review of Food Insecurity on Postsecondary Education Campuses. J. Acad. Nutr. Diet.; 2017; 117, pp. 1767-1791. [DOI: https://dx.doi.org/10.1016/j.jand.2017.05.022] [PubMed: https://www.ncbi.nlm.nih.gov/pubmed/28754200]
22. Ashby, S.; Kleve, S.; McKechnie, R.; Palermo, C. Measurement of the dimensions of food insecurity in developed countries: A systematic literature review. Public Health Nutr.; 2016; 19, pp. 2287-2896. [DOI: https://dx.doi.org/10.1017/S1368980016001166] [PubMed: https://www.ncbi.nlm.nih.gov/pubmed/27217202]
23. Carter, M.; Dubois, L.; Tremblay, M. Place and food insecurity: A critical review and synthesis of the literature. Public Health Nutr.; 2014; 17, pp. 94-112. [DOI: https://dx.doi.org/10.1017/S1368980013000633] [PubMed: https://www.ncbi.nlm.nih.gov/pubmed/23561752]
24. Munn, Z.; Peters, M.D.J.; Stern, C.; Tufanaru, C.; McArthur, A.; Aromataris, E. Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach. BMC Med. Res. Methodol.; 2018; 18, 143. [DOI: https://dx.doi.org/10.1186/s12874-018-0611-x]
25. Peters, M.; Godfrey, C.; Khalil, H.; McInerney, P.; Parker, D.; Soares, C. Guidance for conducting systematic scoping views. Int. J. Evid.-Based Healthc.; 2015; 13, pp. 141-146. [DOI: https://dx.doi.org/10.1097/XEB.0000000000000050] [PubMed: https://www.ncbi.nlm.nih.gov/pubmed/26134548]
26. UNDP. The Human Development Report 2019. Beyond Income, beyond Averages, beyond Today: Inequalities in Human Development in the 21st Century 2019. Available online: http://hdr.undp.org/en/composite/HDI (accessed on 13 March 2020).
27. Covidence. Covidence Systematic Review Software Melbourne, Australia: Veritas Health Innovation. 2020; Available online: https://www.covidence.org (accessed on 20 April 2020).
28. Riva, J.J.; Malik, K.M.P.; Burnie, S.J.; Endicott, A.R.; Busse, J.W. What is your research question? An introduction to the PICOT format for clinicians. J. Can. Chiropr. Assoc.; 2012; 56, 167.
29. Lund, T.B.; Holm, L.; Tetens, I.; Smed, S.; Nielsen, A.L. Food insecurity in Denmark-socio-demographic determinants and associations with eating- and health-related variables. Eur. J. Public Health; 2018; 28, pp. 283-288. [DOI: https://dx.doi.org/10.1093/eurpub/ckx121]
30. Carter, M.A.; Dubois, L.; Tremblay, M.S.; Taljaard, M. Local social environmental factors are associated with household food insecurity in a longitudinal study of children. BMC Public Health; 2012; 12, 1038. [DOI: https://dx.doi.org/10.1186/1471-2458-12-1038]
31. Renzaho, A.M.N. Is a healthy diet affordable and accessible in the City of Yarra, Victoria-Australia? An analysis of cost disparity and nutritional choices. Ecol. Food Nutr.; 2008; 47, pp. 44-63. [DOI: https://dx.doi.org/10.1080/03670240701454725]
32. Alderete, E.; Sonderegger, L.; Pérez-Stable, E. Emerging themes in food security: Environmental justice, extended families and the multiple roles of grandmothers. Int. J. Equity Health; 2018; 17, 139. [DOI: https://dx.doi.org/10.1186/s12939-018-0856-3] [PubMed: https://www.ncbi.nlm.nih.gov/pubmed/30208934]
33. Cheu, L.A.; Yee, L.M.; Kominiarek, M.A. Food insecurity during pregnancy and gestational weight gain. Am. J. Obstet. Gynecol. MFM; 2020; 2, 100068. [DOI: https://dx.doi.org/10.1016/j.ajogmf.2019.100068] [PubMed: https://www.ncbi.nlm.nih.gov/pubmed/33313497]
34. Egeland, G.M.; Pacey, A.; Cao, Z.; Sobol, I. Food insecurity among inuit preschoolers: Nunavut inuit child health survey, 2007–2008. CMAJ; 2010; 182, pp. 243-248. [DOI: https://dx.doi.org/10.1503/cmaj.091297] [PubMed: https://www.ncbi.nlm.nih.gov/pubmed/20100848]
35. Hadley, C.; Sellen, D. Food security and child hunger among recently resettled liberian refugees and asylum seekers: A pilot study. J. Immigr. Minority Health; 2006; 8, pp. 369-375. [DOI: https://dx.doi.org/10.1007/s10903-006-9007-9]
36. King, C. Informal assistance to urban families and the risk of household food insecurity. Soc. Sci. Med.; 2017; 189, pp. 105-113. [DOI: https://dx.doi.org/10.1016/j.socscimed.2017.07.030] [PubMed: https://www.ncbi.nlm.nih.gov/pubmed/28797939]
37. Park, C.Y.; Eicher-Miller, H.A. Iron deficiency is associated with food insecurity in pregnant females in the United States: National Health and Nutrition Examination Survey 1999–2010. J. Acad. Nutr. Diet.; 2014; 114, pp. 1967-1973. [DOI: https://dx.doi.org/10.1016/j.jand.2014.04.025] [PubMed: https://www.ncbi.nlm.nih.gov/pubmed/24953790]
38. Rosas, L.G.; Harley, K.; Fernald, L.C.; Guendelman, S.; Mejia, F.; Neufeld, L.M.; Eskenazi, B. Dietary associations of household food insecurity among children of Mexican descent: Results of a binational study. J. Am. Diet. Assoc.; 2009; 109, pp. 2001-2009. [DOI: https://dx.doi.org/10.1016/j.jada.2009.09.004]
39. Schlichting, D.; Hashemi, L.; Grant, C. Infant Food Security in New Zealand: A Multidimensional Index Developed from Cohort Data. Int. J. Environ. Res. Public Health; 2019; 16, 283. [DOI: https://dx.doi.org/10.3390/ijerph16020283]
40. Skalicky, A.; Meyers, A.F.; Adams, W.G.; Yang, Z.; Cook, J.T.; Frank, D.A. Child food insecurity and iron deficiency anemia in low-income infants and toddlers in the United States. Matern. Child Health J.; 2006; 10, pp. 177-185. [DOI: https://dx.doi.org/10.1007/s10995-005-0036-0]
41. Wong, H.; Moy, F.; Sulochana, N. Risk factors of malnutrition among preschool children in Terengganu, Malaysia: A case control study. BMC Public Health; 2014; 14, 785. [DOI: https://dx.doi.org/10.1186/1471-2458-14-785]
42. Wu, Q.; Harwood, R.L.; Feng, X. Family socioeconomic status and maternal depressive symptoms: Mediation through household food insecurity across five years. Soc. Sci. Med.; 2018; 215, pp. 1-6. [DOI: https://dx.doi.org/10.1016/j.socscimed.2018.08.043]
43. Zalilah, M.S.; Khor, G. Household food insecurity and coping strategies in a poor rural community in Malaysia. Nutr. Res. Pract.; 2008; 2, pp. 26-34.
44. Wong, P.D.; Parkin, P.C.; Moodie, R.G.; Dai, D.W.; Maguire, J.L.; Birken, C.S.; Borkhoff, C.M. Total Breastfeeding Duration and Household Food Insecurity in Healthy Urban Children. Acad. Pediatrics; 2019; 19, pp. 884-890. [DOI: https://dx.doi.org/10.1016/j.acap.2019.02.009]
45. Findlay, L.C.; Langlois, K.A.; Kohen, D.E. Hunger among Inuit children in Canada. Int. J. Circumpolar Health; 2013; 72, 20324. [DOI: https://dx.doi.org/10.3402/ijch.v72i0.20324] [PubMed: https://www.ncbi.nlm.nih.gov/pubmed/23620871]
46. Cook, J.T.; Black, M.; Chilton, M.; Cutts, D.; de Cuba, S.E.; Heeren, T.C.; Rose-Jacobs, R.; Sandel, M.; Casey, P.H.; Coleman, S. et al. Are food insecurity’s health impacts underestimated in the U.S. population? Marginal food security also predicts adverse health outcomes in young U.S. children and mothers. Adv. Nutr.; 2013; 4, pp. 51-61. [DOI: https://dx.doi.org/10.3945/an.112.003228] [PubMed: https://www.ncbi.nlm.nih.gov/pubmed/23319123]
47. King, C. Food insecurity and child behavior problems in fragile families. Econ. Hum. Biol.; 2018; 28, pp. 14-22. [DOI: https://dx.doi.org/10.1016/j.ehb.2017.11.002] [PubMed: https://www.ncbi.nlm.nih.gov/pubmed/29197238]
48. Garg, A.; Toy, S.; Tripodis, Y.; Cook, J.; Cordelia, N. Influence of Maternal Depression on Household Food Insecurity for Low-Income Families. Acad. Pediatrics; 2015; 15, pp. 305-310. [DOI: https://dx.doi.org/10.1016/j.acap.2014.10.002]
49. Lindsay, A.C.; Sussner, K.M.; Greaney, M.L.; Peterson, K.E. Influence of social context on eating, physical activity, and sedentary behaviors of Latina mothers and their preschool-age children. Health Educ. Behav.; 2009; 36, pp. 81-96. [DOI: https://dx.doi.org/10.1177/1090198107308375]
50. Lindsay, A.C.; Ferarro, M.; Franchello, A.; De La Barrera, R.; Machado, M.M.T.; Pfeiffer, M.E.; Peterson, K.E. Child feeding practices and household food insecurity among low-income mothers in Buenos Aires, Argentina. Cienc. Saude Coletiva; 2012; 17, pp. 661-669. [DOI: https://dx.doi.org/10.1590/S1413-81232012000300012]
51. Ward, A.L.; Galland, B.C.; Haszard, J.J.; Meredith-Jones, K.; Morrison, S.; McIntosh, D.R.; Jackson, R.; Beebe, D.W.; Fangupo, L.; Richards, R. et al. The effect of mild sleep deprivation on diet and eating behaviour in children: Protocol for the Daily Rest, Eating, and Activity Monitoring (DREAM) randomized cross-over trial. BMC Public Health; 2019; 19, 1347. [DOI: https://dx.doi.org/10.1186/s12889-019-7628-x]
52. Patel, S.A.; Surkan, P.J. Unwanted childbearing and household food insecurity in the United States. Matern. Child Nutr.; 2016; 12, pp. 362-372. [DOI: https://dx.doi.org/10.1111/mcn.12143]
53. Ward, W.L.; Swindle, T.M.; Kyzer, A.L.; Edge, N.; Sumrall, J.; Whiteside-Mansell, L. Maternal Depression: Relationship to Food Insecurity and Preschooler Fruit/Vegetable Consumption. Int. J. Environ. Res. Public Health; 2019; 17, 123. [DOI: https://dx.doi.org/10.3390/ijerph17010123] [PubMed: https://www.ncbi.nlm.nih.gov/pubmed/31877981]
54. Meyers, A.; Cutts, D.; Frank, D.A.; Levenson, S.; Skalicky, A.; Heeren, T.; Cook, J.; Berkowitz, C.; Black, M.; Casey, P. Subsidized housing and children’s nutritional status: Data from a multisite surveillance study. Arch. Pediatrics Adolesc. Med.; 2005; 159, pp. 551-556. [DOI: https://dx.doi.org/10.1001/archpedi.159.6.551] [PubMed: https://www.ncbi.nlm.nih.gov/pubmed/15939854]
55. Anderson, L.; Hadzibegovic, D.S.; Moseley, J.M.; Sellen, D.W. Household food insecurity shows associations with food intake, social support utilization and dietary change among refugee adult caregivers resettled in the United States. Ecol. Food Nutr.; 2014; 53, pp. 312-332. [DOI: https://dx.doi.org/10.1080/03670244.2013.831762]
56. Chilton, M.; Black, M.M.; Berkowitz, C.; Casey, P.H.; Cook, J.; Cutts, D.; Jacobs, R.R.; Heeren, T.; de Cuba, S.E.; Coleman, S. et al. Food insecurity and risk of poor health among US-born children of immigrants. Am. J. Public Health; 2009; 99, pp. 556-562. [DOI: https://dx.doi.org/10.2105/AJPH.2008.144394]
57. Neault, N.B.; Frank, D.A.; Merewood, A.; Philipp, B.; Levenson, S.; Cook, J.T.; Meyers, A.F.; Casey, P.H.; Cutts, D.B.; Black, M.M. et al. Breastfeeding and health outcomes among citizen infants of immigrant mothers. J. Am. Diet. Assoc.; 2007; 107, pp. 2077-2086. [DOI: https://dx.doi.org/10.1016/j.jada.2007.09.010] [PubMed: https://www.ncbi.nlm.nih.gov/pubmed/18060893]
58. Tang, M.N.; de Cuba, S.E.; Coleman, S.M.; Heeren, T.; Sandel, M.; Chilton, M.; Frank, D.A.; Huh, S.Y. Maternal Place of Birth, Socioeconomic Characteristics, and Child Health in US-Born Latinx Children in Boston. Acad. Pediatrics; 2020; 20, pp. 225-233. [DOI: https://dx.doi.org/10.1016/j.acap.2019.09.005] [PubMed: https://www.ncbi.nlm.nih.gov/pubmed/31541703]
59. Kreider, B.; Pepper, J.V.; Manan, R.; Gundersen, C.; Ziliak, J.P. Identifying the effects of WIC on food insecurity among infants and children. South. Econ. J.; 2016; 82, pp. 1106-1122. [DOI: https://dx.doi.org/10.1002/soej.12078]
60. Trappmann, J.L.; Jimenez, E.Y.; Keane, P.C.; Cohen, D.A.; Davis, S.M. Cross-Sectional Relationships Between Household Food Insecurity and Child BMI, Feeding Behaviors, and Public Assistance Utilization Among Head Start Children From Predominantly Hispanic and American Indian Communities in the CHILE Study. J. Hunger. Environ. Nutr.; 2015; 10, pp. 439-455. [DOI: https://dx.doi.org/10.1080/19320248.2014.962770]
61. Loopstra, R. Interventions to address household food insecruity in high-income countires. Proc. Nutr. Soc.; 2018; 77, pp. 270-281. [DOI: https://dx.doi.org/10.1017/S002966511800006X]
62. Australian Human Rights Commission. Face the Facts: Gender Equality 2018. 2018; Available online: https://humanrights.gov.au/our-work/education/face-facts-gender-equality-2018 (accessed on 20 July 2020).
63. Carter, K.N.; Kruse, K.; Blakely, T.; Collings, S. The association of food security with psychological distress in New Zealand and any gender differences. Soc. Sci. Med.; 2011; 72, pp. 1463-1471. [DOI: https://dx.doi.org/10.1016/j.socscimed.2011.03.009]
64. Kirkpatrick, S.; McIntyre, L.; Potestio, M.L. Child hunger and long term adverse consequences for health. Arch. Pediatrics Adolesc. Med.; 2010; 164, pp. 754-762. [DOI: https://dx.doi.org/10.1001/archpediatrics.2010.117] [PubMed: https://www.ncbi.nlm.nih.gov/pubmed/20679167]
65. Maggi, S.; Irwin, L.; Siddiqi, A.; Hertzman, C. The social determinants of early child development: An overview. J. Paediatr. Child Health; 2010; 41, pp. 627-635. [DOI: https://dx.doi.org/10.1111/j.1440-1754.2010.01817.x] [PubMed: https://www.ncbi.nlm.nih.gov/pubmed/20796183]
66. Masoodi, M.A. Comparative analysis of two qualitative methods: Deciding between grounded theory and phenomenology for your research. Vocat. Train. Res. Realities; 2017; 28, pp. 23-40.
© 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.
Details
; Stern, Katie 2 ; Paige van der Pligt 1 ; McNaughton, Sarah A 1 ; Lindberg, Rebecca 1 1 Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Locked Bag 2000, Geelong, VIC 3220, Australia;
2 Gretchen Swanston Centre for Nutrition, 8401 W Dodge Rd, Omaha, NE 68114, USA;
3 Institute for Health Transformation, School of Health and Social Development, Deakin University, Locked Bag 2000, Geelong, VIC 3220, Australia;