BackgroundFood insecurity among Mexican-origin and Hispanic households is a critical nutritional health issue of national importance. At the same time, nutrition-related health conditions, such as obesity and type 2 diabetes, are increasing in Mexican-origin youth. Risk factors for obesity and type 2 diabetes are more common in Mexican-origin children and include increased intakes of energy-dense and nutrient-poor foods. This study assessed the relationship between children's experience of food insecurity and nutrient intake from food and beverages among Mexican-origin children (age 6-11 y) who resided in Texas border colonias.MethodsBaseline data from 50 Mexican-origin children were collected in the home by trained promotora-researchers. All survey (demographics and nine-item child food security measure) and 24-hour dietary recall data were collected in Spanish. Dietary data were collected in person on three occasions using a multiple-pass approach; nutrient intakes were calculated with NDS-R software. Separate multiple regression models were individually fitted for total energy, protein, dietary fiber, calcium, vitamin D, potassium, sodium, Vitamin C, and percentage of calories from fat and added sugars.ResultsThirty-two children (64%) reported low or very low food security. Few children met the recommendations for calcium, dietary fiber, and sodium; and none for potassium or vitamin D. Weekend intake was lower than weekday for calcium, vitamin D, potassium, and vitamin C; and higher for percent of calories from fat. Three-day average dietary intakes of total calories, protein, and percent of calories from added sugars increased with declining food security status. Very low food security was associated with greater intakes of total energy, calcium, and percentage of calories from fat and added sugar.ConclusionsThis paper not only emphasizes the alarming rates of food insecurity for this Hispanic subgroup, but describes the associations for food insecurity and diet among this sample of Mexican-origin children. Child-reported food insecurity situations could serve as a screen for nutrition problems in children. Further, the National School Lunch and School Breakfast Programs, which play a major beneficial role in children's weekday intakes, may not be enough to keep pace with the nutritional needs of low and very low food secure Mexican-origin children.

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BackgroundFew studies have focused on the relationship between the retail food environment and household food supplies. This study examines spatial access to retail food stores, food shopping habits, and nutrients available in household food supplies among 50 Mexican-origin families residing in Texas border colonias.MethodsThe design was cross-sectional; data were collected in the home March to June 2010 by promotora-researchers. Ground-truthed methods enumerated traditional (supercenters, supermarkets, grocery stores), convenience (convenience stores and food marts), and non-traditional (dollar stores, discount stores) retail food stores. Spatial access was computed using the network distance from each participant’s residence to each food store. Data included survey data and two household food inventories (HFI) of the presence and amount of food items in the home. The Spanish language interviewer-administered survey included demographics, transportation access, food purchasing, food and nutrition assistance program participation, and the 18-item Core Food Security Module. Nutrition Data Systems for Research (NDS-R) was used to calculate HFI nutrients. Adult equivalent adjustment constants (AE), based on age and gender calorie needs, were calculated based on the age- and gender composition of each household and used to adjust HFI nutrients for household composition. Data were analyzed using bivariate analysis and linear regression models to determine the association of independent variables with the availability of each AE-adjusted nutrient.ResultsRegression models showed that households in which the child independently purchased food from a convenience store at least once a week had foods and beverages with increased amounts of total energy, total fat, and saturated fat. A greater distance to the nearest convenience store was associated with reduced amounts of total energy, vitamin D, total sugar, added sugar, total fat, and saturated fat. Participation in the National School Lunch Program (NSLP) was associated with lower household levels of total energy, calcium, vitamin C, sodium, vitamin D, and saturated fat. Spatial access and utilization of supermarkets and dollar stores were not associated with nutrient availability.ConclusionsAlthough household members frequently purchased food items from supermarkets or dollar stores, it was spatial access to and frequent utilization of convenience food stores that influenced the amount of nutrients present in Texas border colonia households. These findings also suggest that households which participate in NSLP have reduced AE-adjusted nutrients available in the home. The next step will target changes within convenience stores to improve in-store marketing of foods and beverages to children and adults.

BACKGROUND: Low case volume has been associated with poorer surgical outcomes in a multitude of surgical procedures. We studied the association among low case volume, outcomes, and the likelihood of pediatric liver transplantation.

BackgroundFood insecurity is associated with detrimental physical, psychological, behavioral, social, and educational functioning in children and adults. Greater than one-quarter of all Hispanic households in the U.S. are food insecure. Hispanic families in the U.S. comprise 30% of households with food insecurity at the child level, the most severe form of the condition.MethodsFood security discordance was evaluated among 50 Mexican-origin children ages 6–11 and their mothers living in Texas border colonias from March to June 2010. Mothers and children were interviewed separately using promotora-researcher administered Spanish versions of the Household Food Security Survey Module and the Food Security Survey Module for Youth. Cohen’s kappa statistic (κ) was used to analyze dyadic agreement of food security constructs and level of food security.ResultsEighty percent of mothers reported household food insecurity while 64% of children identified food insecurity at the child level. There was slight inter-rater agreement in food security status (κ = 0.13, p = 0.15). Poor agreement was observed on the child hunger construct (κ = −0.06, p = 0.66) with fair agreement in children not eating for a full day (κ = 0.26, p < 0.01) and relying on low-cost foods (κ = 0.23, p = 0.05).ConclusionsMother and child-reported household and child-level food insecurity among this sample of limited-resource Mexican-origin colonias residents far surpass national estimates. While the level of dyadic agreement was poor, discordance may be attributable to parental buffering, social desirability in responses, and/or the age of children included in the present analysis. Future research should continue to explore how food security is understood from the perspectives and experiences of children and adolescents.