Food insecurity and nutritional insecurity

While food insecurity has long been a focus of local and national policymakers and researchers, nutritional insecurity has been largely overlooked. A new study from the Institute for Food System Equity (IFSE) in the USC Dornsife College of Letters, Arts and Sciences aims to change that.

The study was published as follows: Nutrition Journal.

This is the first study to identify populations most affected by nutrition insecurity, as opposed to food insecurity, in Los Angeles County. Nutrition insecurity refers to a lack of access to healthy foods that meet personal preferences, including cultural, religious, and dietary needs, while food insecurity focuses simply on a lack of access to adequate food.

The study also compared specific health consequences of nutritious food deficiencies with the consequences of general food deficiencies.

The vast majority of Americans do not follow a nutritious diet because many factors, including cost, access, and time, make it very difficult to do so.

• Nutritional insecurity has not been analyzed as comprehensively as food insecurity, resulting in knowledge gaps about how to address it and the specific health problems that are directly linked to nutrition insecurity.
• Nationwide, malnutrition is a leading cause of death. To address the problem, it is important to know which demographic groups are most affected by nutritional insecurity.

“To address leading causes of chronic diseases like diabetes and mental health issues, we need to track both nutrition insecurity and food insecurity in Los Angeles County,” said Kayla de la Haye, founding director of IFSE at USC Dornsife’s Center for Economic and Social Research. “Addressing food insecurity is critical to ensuring people have enough food, but we also need to understand who faces barriers to eating a healthy diet.”

Researchers surveyed more than 1,000 adults in Los Angeles County between Dec. 5, 2022, and Jan. 4, 2023, to determine rates of food and nutrition insecurity among county residents.

In 2022, nearly one in four people experienced food insecurity. A similar proportion reported experiencing nutrition insecurity. Interestingly, nearly half of those experiencing nutrition insecurity did not report food insecurity, and vice versa.

• Twenty-four percent of Angelenos were food insecure, 25 percent were diet insecure, and 14 percent were food and nutrition insecure. This means that 1.4 million residents do not have enough money to buy food and do not have access to foods that are both healthy and meet their personal preferences.
• Although the 6 million Asian residents (16% of the county population) were not at higher risk for food insecurity, they were more than twice as likely to be nutritionally insecure as white residents. This disparity may be due to a lack of access to foods that are both healthy and culturally appropriate, rather than an inability to afford enough food.
• In contrast, Hispanics, who make up nearly half of the county’s population, are twice as likely to be food insecure as non-Hispanic whites, but are not at higher risk for nutritional insecurity. This indicates a difficulty affording enough food overall, but not a difficulty accessing healthy food that meets their personal preferences.
• Adults ages 18-40 and adults ages 41-64 are nearly 5 times more likely to experience both food and nutrition insecurity than those ages 65 and older.

Nutrition insecurity is prevalent in low- and middle-income countries that face food shortages and malnutrition, but in high-income countries like the United States, access to healthy options is often unequal despite the abundance of food.

The White House emphasized the importance of access to nutritious food by announcing in February that it would allocate nearly $1.7 billion to end hunger and increase healthy diets by 2030.

Both food and nutrition insecurity are valuable predictors of diet-related health outcomes, including diabetes and poor mental health, in Los Angeles County, but not cardiovascular disease, according to the researchers.

• People with no or little food security were twice as likely to have diabetes as those with both food and nutrition security.
• Research suggests that nutritional insecurity is linked to diabetes more than food insecurity.

Both food and nutrition insecurity are equally linked to poor mental health. The study’s findings align with an emerging area of ​​research on “food and mood,” which documents how poor nutrition, a result of food insecurity, increases the risk of depression, anxiety, and stress.

• Those experiencing food insecurity are approximately 4.5 times more likely to have poor mental health compared to those with access to adequate food.
• People with nutritional insecurity are 3.5 times more likely to have poor mental health than those who are well nourished.
• Those who experience both food and nutrition insecurity are three times more likely to have poor mental health compared to those who experience neither.

As a next step, the researchers recommend that governments and public health officials monitor both food and nutrition insecurity, and that food programs try to address both issues to improve access to food and eliminate barriers to healthy eating.

Los Angeles County has long tracked food insecurity and added dietary insecurity metrics to its public health surveillance for the first time in 2023.