In this study, Connell et al. examined food insufficiency,
nutrient intake, and food and nutrition assistance
program participation among a Southern
population using NHANES III data. Five research
questions guided their analysis:
Previous studies of the impact of food insecurity and
hunger on food and nutrient intakes, using both primary
and secondary data, have revealed lower intakes of
several nutrients among women of childbearing age, the
elderly, poor Caucasian women in the Northeast, and
low-income Canadian women. However, little has been
done to define the food insecurity-related nutritional
problems of specific regions of the United States such
as the South. The authors argue that factors unique to
the South, and to particular regions within the South,
warrant the investigation of the effects of food insecurity
on nutrient intake in this region. In addition, no
published studies have attempted to determine the
impact of food assistance programs on the nutrient
intakes of individuals from food-insecure households
in the South.
- Do food-insufficient adults have significantly
different nutrient intakes than food-sufficient adults
after controlling for other influences such as education
level, smoking status, age, gender of the household
head, and body size?
- What is the association between food insufficiency
and nutrient intakes among these adults?
- Are there significant differences in the nutrient
intakes of food-insufficient adults based on participation
in food assistance programs after controlling
for other influences?
- Does the number of food assistance programs
influence nutrient intake?
- What is the association between participation in
food assistance programs and nutrient intakes
among these adults?
Connell et al. used data on adults 18 years and older,
residing in the Southern region of the United States,
for their analysis. They classified individuals as food
insufficient if the household food supply was reported
as “sometimes” or “often” not enough to eat (n=456,
or 6.3 percent of the sample). To examine differences
in nutrient intakes between demographic groups and to
determine the effect of food sufficiency status and
participation in food and nutrition assistance programs
on nutrient intakes, they used several statistical techniques,
including tests for differences in means,
analysis of variance, and multiple regression.
The authors found significant demographic differences
between food-sufficient and food-insufficient adults in
their sample. Those most often reporting food insufficiency
were young, non-White, had low levels of formal
education, lived in female-headed households, or participated
in only one food/nutrition assistance program.
Food-insufficient adults not participating in any food
assistance programs had significantly higher incomes
than program participants did. Adults with more formal
education were less likely to participate. Adults in
female-headed households were most likely to participate
in two programs; adults over 60 were least likely to
participate in any food assistance programs. Significantly
lower intakes of four nutrients were found among those
participating in only one food assistance program
compared with those not participating, but not between
those participating in one program vs. two programs or
in two programs vs. no program.
The authors found a significant positive relationship
between food insufficiency and percent of total calories
from carbohydrates. They found a significant
negative relationship between food insufficiency and
intakes of 10 nutrients. Intakes of two nutrients
increased with program participation.
Connell et al. caution that because the NHANES
survey is intended to be nationally representative, their
ability to generalize results to the Southern region is
limited. In addition, regional differences in diet may
not be well represented in the data because the
Southern sample was drawn only from sites in Florida
and Texas. However, their findings generally agree with
those of other studies using national survey data (for
example, lower intakes of some nutrients among the
food insufficient). Two exceptions are a higher
percentage of calories supplied by carbohydrates in the
sample as a whole, and a positive relationship between
food insufficiency and percent of calories from carbohydrates.
The authors suggest that future research
investigate whether these results are influencing
micronutrient intakes in the Southern population.
Higher sodium intake found among program participants
also deserves further investigation due to the
possible adverse effects of high-sodium diets on health.
Connell et al. argue their findings emphasize the
importance of food and nutrition assistance programs
in continuing to promote access to affordable and
nutritious food for low-income families. In addition,
continued emphasis on nutrition education, such as
that provided by WIC and the Family Nutrition
Program, may help to improve food choices and therefore
nutrient intakes. The authors suggest this will be a
fruitful area for behavioral, educational, and program
evaluation research in the future.