Delivering Food Resources and Kitchen Skills (FoRKS) to Adults with Food Insecurity and Hypertension: A Pilot Study.
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ABSTRACT:
SUBMITTER: Rivera RL
PROVIDER: S-EPMC10051267 | biostudies-literature | 2023 Mar
REPOSITORIES: biostudies-literature
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Delivering Food Resources and Kitchen Skills (FoRKS) to Adults with Food Insecurity and Hypertension: A Pilot Study.
Rivera Rebecca L RL Adams Mariah M Dawkins Emily E Carter Amy A Zhang Xuan X Tu Wanzhu W Peña Armando A Holden Richard J RJ Clark Daniel O DO
Nutrients 20230317 6
Food insecurity affects nearly 50 million Americans and is linked to cardiovascular disease risk factors and health disparities. The purpose of this single-arm pilot study was to determine the feasibility of a 16-week dietitian-led lifestyle intervention to concurrently address food access, nutrition literacy, cooking skills, and hypertension among safety-net primary care adult patients. The Food Resources and Kitchen Skills (FoRKS) intervention provided nutrition education and support for hyper ...[more]
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Project description:IntroductionIndividuals with food insecurity are disproportionately burdened by hypertension (HTN) and type 2 diabetes and face greater barriers to self-managing these conditions.MethodsFood Resources and Kitchen Skills (FoRKS) is an ongoing 2-arm parallel randomized controlled trial (RCT) that will enroll 200 adults (35-75 y) with food insecurity and elevated systolic blood pressure (≥120 mmHg) at a large federally qualified health center (FQHC) network in Central Indiana. Blood pressure is measured using an ambulatory blood pressure monitoring (ABPM) device. The (FoRKS, N = 100) intervention integrates hypertension self-management education and support (SMES) with a home-delivered ingredient kit and cooking skills program (16 weeks). Enhanced Usual Care (EUC, N = 100) includes usual care services by the FQHC network, SMES classes (separate from FoRKS), and grocery assistance. This paper describes the protocol for this RCT that will: 1) test the efficacy of FoRKS compared to EUC for reducing systolic blood pressure using an intention to treat protocol, 2) identify behavior change levers (e.g., engagement, social support) and their associations with change in food insecurity, diet quality, and systolic blood pressure, 3) examine the maintenance of outcomes, and 4) assess cost-effectiveness.ConclusionsEstablishing that a food insecurity and SMES intervention, compared to usual care services, is feasible in FQHCs and efficacious for improving blood pressure and related outcomes would have important public health implications. Understanding the behavior change levers of FoRKS that are associated with changes in health outcomes, whether these outcomes are maintained, and its cost-effectiveness will inform future efforts to address health disparities.
| S-EPMC11801624 | biostudies-literature
Project description:BACKGROUND:Limited attention has been paid to an association between food environment and household economic resources related to food expenditure in food-insecure seniors. The aim of the study was to investigate the relationship between factors of economic resource, food environment, and food insecurity in single seniors residing in rural areas of South Korea. METHODS:A cross-sectional study was conducted in 170 single senior households aged 65 years or over residing in rural areas. Face-to-face interviews were performed to collect data on demographic characteristics, household economic resources/expenditure, food environmental factors, and food insecurity. RESULTS:Among economic resources, generally limited food expenditures due to housing fees and heating costs during the winter were positively related to food insecurity. Among food environmental factors, food accessibility at community level such as food stores located far from home and inconvenient bus routes was related to food insecurity. The most explainable economic and food environment factors related to food insecurity by stepwise logistic regression analysis were the percentage of total expenditure on housing fee (OR = 1.021, 95% CI: 1.008-1.034), foods purchasing at super supermarket (OR = 0.398, 95% CI: 0.166-0.951), having difficulties in food purchasing due to food stores being located far from home (OR = 14.487, 95% CI: 5.139-40.842) and inconvenient bus routes (OR = 0.083, 95% CI: 0.015-0.460). CONCLUSION:Inadequate community food environment as well as limited household food resources were an important risk factor for food insecurity in Korean single rural seniors. Findings of this study could help us better understand how characteristics of household food resources and community food environment can serve as barriers or facilitators of food security among single older adults residing in rural areas.
| S-EPMC6712872 | biostudies-other
Project description:The obesity epidemic continues to challenge global health, driven by multifaceted environmental and biological factors. Here, we investigate the impact of food insecurity, characterized by unpredictable food access, on body weight, food intake, and body composition in mice. Male and female C57BL/6J mice were subjected to a combination of intermittent fasting and 5% calorie restriction to resemble food insecurity situations. Our results reveal that this novel food insecurity model promotes fat accumulation and decreases lean mass in both sexes on a standard chow diet. While food insecurity did not exacerbate fat gain in male mice fed a high-fat diet, it further reduced lean mass. RNA sequencing of epididymal white adipose tissue from food-insecure male mice identified upregulated lipid metabolism genes and downregulated immune response genes, suggesting adipocyte expansion and potential immunity dysfunction. These results challenge the traditional view that obesity is solely driven by positive energy balance. Instead, our findings highlight the role of food insecurity in promoting metabolic adaptations favouring fat storage. Our data provide biological mechanisms that may explain the dramatic rise in obesity, underscoring the importance of socio-economic factors, beyond diet composition and energy balance, in understanding the complex etiology of obesity.
2025-06-04 | GSE274149 | GEO
Project description:BackgroundThe relationship between disability and food insecurity is under-researched. Risk of food insecurity may vary by type and number of disabilities. We examine the hypotheses that (i) a higher number of disabilities increases risk of food insecurity and (ii) associations of physical disabilities, mental/cognitive disabilities or a combination of both types with food insecurity may differ in strength.MethodsData came from the fifth wave of the UK's Food Standards Agency's Food and You survey (2018), which contains detailed information on disability and household food insecurity. We used logistic and multinomial logistic regression to model the number and type of disabilities as predictors for food insecurity outcomes, controlling for socio-demographic factors.ResultsBoth type and number of disabilities predicted food insecurity. Every additional disability was associated with higher odds of food insecurity [odds ratio (OR): 1.60, 95% confidence interval (CI): 1.40-1.83]. Among people with a disability, every additional disability was associated with 19% higher odds of food insecurity (OR: 1.19, 95% CI: 1.05-1.34). People with both physical and mental/cognitive disabilities had increased odds of severe food insecurity (OR: 8.97, 95% CI: 3.54-22.7).ConclusionNumber and type of disabilities are associated with higher risk of food insecurity. A combination of physical and mental/cognitive disabilities, as well as having multiple disabilities are each independently associated with higher risk of food insecurity. Policy-makers may thus consider using targeted and tailored policies to reduce barriers to social and financial inclusion of disabled people to reduce food insecurity.
| S-EPMC9341842 | biostudies-literature
Project description:BackgroundFood insecurity (FIS), characterized by the lack of consistent access to nutritious food, is associated with hypertension and adverse health outcomes. Despite evidence of a higher prevalence of hypertension (HTN) in patients living with FIS, there is limited data exploring the underlying mechanism.MethodsWe conducted a cross-sectional analysis of 17,015 adults aged 18-65 years, using dietary recall data from the National Health and Nutrition Examination Survey (2011-2018). Univariate and multivariable analyses were used to examine the association between FIS, HTN, and dietary sodium and potassium levels.ResultsIndividuals reporting FIS had a significantly lower mean intake of potassium (2.5±0.03 gm) compared to those in food-secure households (2.74±0.02 gm). No significant difference was found in the mean dietary sodium intake based on food security status. Non-Hispanic Black participants showed a high prevalence of HTN and FIS. While Non-Hispanic White and Hispanic participants had a high prevalence of FIS, it did not appear to influence their risk of HTN.ConclusionsAdults with FIS and HTN were more likely to report a lower dietary potassium intake. Increasing access to healthy foods, particularly potassium-rich foods, for individuals facing FIS, may contribute to reducing the HTN prevalence and improving cardiovascular outcomes.
| S-EPMC10863033 | biostudies-literature
Project description:BackgroundMedical Kitchen is an innovative transdisciplinary simulation aimed at helping 2nd-year medical students at Imperial College London transition from declarative to procedural knowledge acquisition and prepare them for learning clinical skills, grounded in established psychomotor skills development theories, including Kovacs' definitions and the Fitts and Posner's model.ApproachIt employs a transdisciplinary simulation approach that blends professional gastronomy with medical training. Designed initially in response to the 2020 Covid-19 pandemic, the course offers a scalable and replicable model that includes mechanisms for peer feedback and reflective exercises.EvaluationThe responses for these exercises were analysed thematically to gauge the course's effectiveness. Findings suggest that the Medical Kitchen succeeds in creating a low-stakes, safe learning environment that not only enhances practical skill learning but also emphasises the crucial non-technical skills needed in medical practice.ImplicationsThe Medical Kitchen represents a forward-thinking strategy for medical educators seeking to improve procedural skill training, warranting further research into the long-term impacts of the course on student outcomes.
| S-EPMC11889704 | biostudies-literature
Project description:ObjectiveThe objective of the current work was to determine the association between food insecurity and frailty in older adults, within the context of a country with accelerated ageing and nutritional problems.DesignCross-sectional analysis of a representative nationwide survey on health and nutrition.SettingMexican nationwide survey.SubjectsA sample of 7108 adults aged 60 years or older living in communities, representative of Mexican older adults.ResultsMultivariate regression and descriptive analyses of food insecurity and frailty were performed. From a total of 7108 adults aged 60 years or older, with a mean age of 70·7 years, most (54·7 %) were women. Food security categories were: 26·3 % had food security, 40·3 % had mild food insecurity, 20·5 % had moderate food insecurity and 12·9 % had severe food insecurity. Food insecurity categories were associated with frailty, with the severe category having the highest odds ratio of 2·41 (95 % CI 2·03, 2·86; P<0·001) after adjustment for confounding factors.ConclusionsAccording to our results, food insecurity is associated to frailty, which in turn is a condition that renders the older adult at a higher risk of developing adverse outcomes. Targeted food programmes for older adults with a high risk of having food insecurity or of being frail may improve health in this population group.
| S-EPMC10270913 | biostudies-literature
Project description:BackgroundFood insecurity (FIS) is an important public health issue associated with cardiovascular risk. Given the association of FIS with diets of poorer nutritional quality and higher salt intake as well as chronic stress, numerous studies have explored the link between FIS and hypertension. However, no systematic review or meta-analysis has yet to integrate or analyze the existing literature.MethodsWe performed a wide and inclusive search of peer-reviewed quantitative data exploring FIS and hypertension. A broad-terms, systematic search of the literature was conducted in PubMed, Embase, Scopus, and Web of Science for all English-language, human studies containing primary data on the relationship between FIS and hypertension. Patient population characteristics, study size, and method to explore hypertension were extracted from each study. Effect sizes including odds ratios and standardized mean differences were extracted or calculated based on studies' primary data. Comparable studies were combined by the random effects model for meta-analyses along with assessment of heterogeneity and publication bias.ResultsA total of 36 studies were included in the final analyses. The studies were combined into different subgroups for meta-analyses as there were important differences in patient population characteristics, methodology to assess hypertension, and choice of effect size reporting (or calculability from primary data). For adults, there were no significantly increased odds of elevated blood pressures for food insecure individuals in studies where researchers measured the blood pressures: OR = 0.91 [95%CI: 0.79, 1.04; n = 29,781; Q(df = 6) = 7.6; I2 = 21%]. This remained true upon analysis of studies which adjusted for subject BMI. Similarly, in studies for which the standardized mean difference was calculable, there was no significant difference in measured blood pressures between food secure and FIS individuals: g = 0.00 [95%CI: -0.04, 0.05; n = 12,122; Q(df = 4) = 3.6; I2 = 0%]. As for retrospective studies that inspected medical records for diagnosis of hypertension, there were no significantly increased odds of hypertension in food insecure adults: OR = 1.11 [95%CI: 0.86, 1.42; n = 2,887; Q(df = 2) = 0.7; I2 = 0%]. In contrast, there was a significant association between food insecurity and self-reports of previous diagnoses of hypertension: 1.46 [95%CI: 1.13, 1.88; n = 127,467; Q(df = 7) = 235; I2 = 97%]. Only five pediatric studies were identified which together showed a significant association between FIS and hypertension: OR = 1.44 [95%CI: 1.16, 1.79; n = 19,038; Q(df = 4) = 5.7; I2 = 30%]. However, the small number of pediatric studies were not sufficient for subgroup meta-analyses based on individual study methodologies.DiscussionIn this systematic review and meta-analysis, an association was found between adult FIS and self-reported hypertension, but not with hypertension determined by blood pressure measurement or chart review. Further, while there is evidence of an association between FIS and hypertension among pediatric subjects, the limited number of studies precluded a deeper analysis of this association. These data highlight the need for more rigorous and longitudinal investigations of the relationship between FIS and hypertension in adult and pediatric populations.
| S-EPMC7671545 | biostudies-literature
Project description:IntroductionHousehold food insecurity, defined as inconsistent access to sufficient food in a household, affects 1 in 15 individuals over the age of 60 years in the US. In these individuals it is associated with numerous chronic conditions, medication underuse leading to poorly controlled conditions such as diabetes and hypertension, and poor oral health. However, the relationship between food insecurity and oral health is understudied. We therefore evaluated the associations between food insecurity and aspects of oral health in older US adults.MethodsWe prospectively evaluated a subset of participants of the Health and Retirement Study (HRS) who responded to questions evaluating food insecurity in 2013 and a supplemental questionnaire regarding dental health and dental health services in 2018 (N = 472).ResultsApproximately 1 in 5 people in our study reported being food insecure in the last year. Food insecurity was correlated with poor oral health-related quality of life scores and more tooth loss. Individuals who were food insecure reported worse self-rated oral health (OR = 2.67), greater odds of losing 8 or more teeth (OR = 2.35), and lower odds of receiving oral care (OR = 0.60) compared to their food secure peers.ConclusionsThough individuals experiencing food insecurity were likely to have more unmet oral health needs than their peers, they were less likely to seek dental care. To improve the oral health status of this group, in addition to making oral health care more accessible, it may also be necessary to address the social and environmental factors preventing these people from seeking oral health care.
| S-EPMC11540812 | biostudies-literature
Project description:BackgroundThe prevalence of food insecurity and food insufficiency is high among homeless people. We investigated the prevalence and correlates of food insecurity among a cohort of homeless adults with mental illness in Vancouver, British Columbia, Canada.MethodsData collected from baseline questionnaires in the Vancouver At Home study were analysed to calculate the prevalence of food insecurity within the sample (n = 421). A modified version of the U.S. Department of Agriculture's Adult Food Security Survey Module was used to ascertain food insecurity. Univariable and multivariable logistic regression were used to examine potential correlates of food insecurity.ResultsThe prevalence of food insecurity was 64%. In the multivariable model, food insecurity was significantly associated with age (adjusted odds ratio [aOR] = 0.97; 95% CI: 0.95-0.99), less than high school completion (aOR = 0.57; 95% CI: 0.35-0.93), needing health care but not receiving it (aOR = 1.65; 95% CI: 1.00-2.72), subjective mental health (aOR = 0.97; 95% CI: 0.96-0.99), having spent over $500 for drugs and alcohol in the past month (aOR = 2.25; 95% CI: 1.16-4.36), HIV/AIDS (aOR = 4.20; 95% CI: 1.36-12.96), heart disease (aOR = 0.39; 95% CI: 0.16-0.97) and having gone to a drop-in centre, community meal centre or program/food bank (aOR = 1.65; 95% CI: 1.01-2.68).ConclusionsThe prevalence of food insecurity was extremely high in a cohort with longstanding homelessness and serious mental illness. Younger age, needing health care but not receiving it, poorer subjective mental health, having spent over $500 for drugs and alcohol in the past month, HIV/AIDS and having gone to a drop-in centre, community meal centre or program/food bank each increased odds of food insecurity, while less than high school completion and heart disease each decreased odds of food insecurity. Interventions to reduce food insecurity in this population are urgently needed.
| S-EPMC4954689 | biostudies-literature