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Direct and Indirect Effects of Food and Nutrition Security on Dietary Choice and Healthfulness of Food Choice: Causal Mediation Analysis.


ABSTRACT:

Background

Links between diet and food security are well established, but less is known about how food and nutrition security affect a household's ability to decide what to consume.

Objectives

This study's purpose was to quantify and compare causal pathways from 1) food and nutrition security to perceived dietary choice and 2) food and nutrition security to perceived healthfulness of food choice while testing for mediation by perceived limited availability of foods and utilization barriers to healthful meals.

Methods

Causal mediation analysis was conducted using an observational data set. Exposures included food insecurity and nutrition insecurity; mediators included perceived limited availability and utilization barriers; outcomes included perceived dietary choice and healthfulness choice; covariates included income and education.

Results

Dietary choice (range 0-4) was 0.9 to 1.1 points lower for participants with food/nutrition insecurity compared with participants with food/nutrition security (direct effects). Neither mediation nor moderation by perceived limited availability were present. Seventeen percent and 11 %, respectively, of the effects of food and nutrition security on dietary choice could be contributed to utilization barriers (mediation). Moderation by utilization barriers was present only for nutrition security (differences in dietary choice only present when barriers were low). Healthfulness choice (range 0-4) was 0.6 to 0.7 points lower for participants with food/nutrition insecurity compared with participants with food/nutrition security (direct effects). Mediation by perceived limited availability and utilization barriers was not present. Moderation was present only for nutrition security (differences in healthfulness choice only present when perceived limited availability was low; differences in healthfulness choice only present when barriers were low).

Conclusions

Food and nutrition security affect food choices, with utilization barriers acting as an intermediary step. When environmental and household utilization barriers to healthful food purchasing and preparation are high, the ability to decide what to consume does not differ between households with nutrition security and those with nutrition insecurity.

SUBMITTER: Thomson JL 

PROVIDER: S-EPMC10847738 | biostudies-literature | 2024 Feb

REPOSITORIES: biostudies-literature

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Publications

Direct and Indirect Effects of Food and Nutrition Security on Dietary Choice and Healthfulness of Food Choice: Causal Mediation Analysis.

Thomson Jessica L JL   Landry Alicia S AS   Walls Tameka I TI  

Current developments in nutrition 20240113 2


<h4>Background</h4>Links between diet and food security are well established, but less is known about how food and nutrition security affect a household's ability to decide what to consume.<h4>Objectives</h4>This study's purpose was to quantify and compare causal pathways from <i>1</i>) food and nutrition security to perceived dietary choice and <i>2</i>) food and nutrition security to perceived healthfulness of food choice while testing for mediation by perceived limited availability of foods a  ...[more]

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