USDA expert links lower food and nutrition security to constrained dietary choices

02 Feb 2024 --- The dietary choices of people with low food and nutrition security are more constrained than those whose food and nutrition needs are met, finds a new study conducted by experts at the US Department of Agriculture (USDA) and the University of Central Arkansas, US.

Nutrition Insight speaks to Dr. Jessica Thomson, co-author of the study and a research epidemiologist at the USDA Agricultural Research Service, about her findings.

“The direct effects of food and nutrition security on dietary choice that we observed in our study suggest that individuals with lower security feel that they do not have as much control over their food choices as do individuals with food or nutrition security. They believe that external limitations, such as affordability, are affecting their ability to acquire healthful foods and foods that they prefer,” Thomson explains. 

Dr. Jessica Thomson, research epidemiologist at the USDA Agricultural Research Service.“The finding that utilization barriers is an intermediary step in the pathways between food and nutrition security, and food choice suggests that it’s not just lack of financial resources that affects one’s ability to choose healthful foods but also lack of equipment and knowledge for preparing healthful foods,” she adds. 

Food and nutrition security 
The research paper published in the Current Developments in Nutrition journal used observational data collected by researchers at the Gretchen Swanson Center for Nutrition collected from households at risk of experiencing food insecurity. The researchers conducted a causal mediation analysis of the data to identify causal pathways between  food and nutrition security and dietary choice. 

The study differentiates between food and nutrition security, with food security being defined as the ability to acquire enough food and nutrition security as the ability to acquire enough health promoting food. 

“Food security is an established metric for monitoring food insufficiency in the US,” Thomson details. “Relatively recently, however, there has been a shift from focusing on financial aspects of food insufficiency to the nutritional quality of foods people can afford.” 

She notes a shift from the focus on “can individuals afford enough food to satisfy hunger” to whether they can afford “enough food to satisfy hunger and support health.” 

“Researchers are just beginning to explore how food and nutrition security contribute differently to food choice and that is the reason we chose to focus on both types of security. Based on the results of our study, there are some differences, but there also are similarities between food and nutrition security effects on food choice.” 

“For example, the healthfulness of food choice was lower for individuals with food insecurity regardless of whether they believed food availability was limited or not,” Thomson details. “However, healthfulness choice was only lower for individuals with nutrition insecurity when they believed food availability was not limited. Stated another way, when perceived limited food availability was high, the healthfulness of food choice did not differ between individuals with nutrition security and those with nutrition insecurity.” 

The perception of limitations and barriers 
The study identifies participants’ perceived limited availability of food groups and utilization barriers as standing between food and nutrition security and food choice. 

USDA research finds food and nutrition security affect dietary choices, with utilization barriers playing an intermediary role.“Perceived limited availability of foods in stores was assessed by asking individuals where they shopped for food. This was followed by three questions that asked about the food that was available in the places they shopped — few quality fruits and vegetables, few foods that were liked, and few foods that were good for health,” explains Thomson. 

“Utilization barriers are things that make it difficult for individuals to safely prepare and store foods available to them,” she adds. “Barriers were assessed with eight questions about food storage (e.g., access to a refrigerator), cooking equipment (e.g., stove), cooking utensils (e.g., pots and pans), sanitary food preparation area, knowledge on how to select healthful foods, scratch-cooking and healthy cooking skills and time to cook meals.” 

Thomson tells us that the study finds that utilization barriers and not perceived limited availability of foods in stores affect pathways between food and nutrition security and dietary choice.

“This suggests that utilization barriers are partially responsible for the effects of food and nutrition security on dietary choice but not necessarily for healthfulness of food choice.”

“However, we did find that the effects of nutrition security on dietary choice and healthfulness choice depended on the level of perceived limited availability and number of utilization barriers. Effects were only present (or stronger) when either perceived limited availability was low or utilization barriers were low,” she continues. 

Income and education
The study includes participants’ income and level of education as independent variables that can influence the outcome. 

“Income did not appear to impact dietary choice or healthfulness choice,” Thomson identifies. “While this result was a bit surprising to us, it’s likely because individuals were recruited from organizations that work with households at risk for or experiencing food insecurity. Such households tend to have lower income than households with food security.” 

“Education did impact healthfulness choice but not dietary choice. We found this result quite interesting because it suggests that education plays a bigger role in healthful food choices versus food choices in general,” she continues.

Policy recommendations 
The research paper concludes that food and nutrition security affect people’s dietary choices, with utilization barriers playing an intermediary role. 

Based on the study outcomes, Thomson offers recommendations to practitioners and policymakers looking to improve the dietary choices of people with low food and nutrition security.

She states that interventions designed to improve knowledge and cooking skills may positively affect food choice, while pointing out that “they will not have much of an effect unless individuals have the tools to store, prepare and cook healthful foods.”

“Strategies and policies that remove household utilization barriers to acquiring healthful foods are needed. USDA is dedicated to improving food and nutrition security for the US population and we do have existing policies, programs and initiatives in place for doing this.”

“For example, ASCEND for Better Health is a new virtual center that brings together scientists, partner organizations and communities to deliver science-based solutions that promote and elevate food and nutrition security for all US residents,” Thomson concludes.

By Milana Nikolova