Objective: To examine associations between household food insecurity and children’s physical activity and sedentary behaviors. Design: Secondary analysis was conducted on the Healthy Communities Study, an observational study from 2013-2015. Household food insecurity was assessed by two items from the US Department of Agriculture’s 18-item US Household Food Security Survey Module. Physical activity was measured using the 7-day Physical Activity Behavior Recall instrument. Data were analyzed using multilevel statistical modeling. Setting: 130 communities in the US. Participants: 5,138 US children ages 4-15 years. Results: No associations were found for the relationship between household food insecurity and child physical activity. A significant interaction between household food insecurity and child sex for sedentary behaviors was observed (P=0.03). Conclusions: Additional research capturing a more detailed assessment of children’s experiences of food insecurity in relation to physical activity is warranted. Future studies may consider adopting qualitative study designs or utilizing food insecurity measures that specifically target child-level food insecurity. Subsequent research may also seek to further explore sub-group analyses by sex.
In 2020, nearly 9.5 million (or about 8 percent of) adults ages 50 and older were food-insecure, meaning they had limited or uncertain access to adequate food. 1 The Supplemental Nutrition Assistance Program (SNAP) is the nation's largest antihunger program and helps millions of people who are at risk for food insecurity. SNAP provides financial assistance to many lowincome individuals and families to help buy the food they need. The program may also improve health and lower health care costs. Research shows that SNAP enrollment among older adults is associated with fewer hospital and emergency room visits and long-term care admissions. 2 Despite the program's potential benefits, eligible older adults have historically had much lower participation in SNAP than those in other age groups. The U.S. Department of Agriculture reports that in fiscal year 2018, only 48 percent of eligible adults ages 60 and older participated in the program under federal rules. 3 The percentage is substantially lower when calculated using state-specific eligibility rules. Although using federal eligibility rules is useful for state comparisons, using state-specific eligibility rules (which vary widely) better reflects the actual number of older adults eligible by state. Using that measure, we estimate a substantially lower participation rate of 29 percent among this age group.Qualitative research has identified common reasons for low participation in SNAP, such as a confusing and burdensome application process, stigma, and discomfort with technology. 4 Quantitative data help us understand who is not enrolling in SNAP and is important for addressing low program enrollment, yet little is known about the characteristics of eligible older nonparticipants. Using estimates from Mathematica, this Spotlight examines that question.
Objectives Childcare is an important setting for nutrition; nearly half of young children in the United States participate in licensed childcare, where they consume up to two-thirds of their daily dietary intake. We compared state regulations for childcare with best practices to support breastfeeding and healthy beverage provision. Methods We reviewed regulations for childcare centers (centers) and family childcare homes (homes) in effect May–July 2016 and rated all 50 states for inclusion (1 = not included, 2 = partially included, 3 = fully included) of 12 breastfeeding and beverage best practices. We calculated average ratings for 6 practices specific to infants aged 0-11 months, 6 practices specific to children aged 1-6 years, and all 12 practices, by state and across all states. We assessed significant differences between centers and homes for each best practice by using McNemar–Bowker tests for symmetry, and we assessed differences across states by using paired student t tests. Results States included best practices in regulations for centers more often than for homes. Average ratings (standard deviations) in regulations across all states were significantly higher in centers than in homes for infant best practices (2.1 [0.5] vs 1.8 [0.5], P < .001), child best practices (2.1 [0.6] vs 1.8 [0.6], P = .002), and all 12 best practices combined (2.1 [0.5] vs 1.8 [0.6], P < .001). Conclusions Although best practices were more consistently included in regulations for centers than for homes, many state childcare regulations did not include best practices to support breastfeeding and the provision of healthy beverages. Findings can be used to inform efforts to improve regulations and to reduce differences between centers and homes.
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