A Systematic Literature Review of Nutrition Interventions Implemented to Address Food Insecurity as a Social Determinant of Health

Abstract

Background: Policy initiatives have provided funding for non-acute nutrition interventions to address food insecurity as a social determinant of health, but more research is needed to understand the outcomes of these initiatives in order to determine the areas of highest impact. Therefore, the purpose of this systematic review was to evaluate the outcomes that were assessed in three nutrition interventions (produce prescription programs, medically tailored meals, and community supported agriculture) that aim to address food insecurity as a social determinant of health, and this was undertaken in order to identify future areas of study that can heighten impact. Methods: This systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) criteria. A list of search terms and keywords were compiled by the research team. A Boolean search was conducted from 1 January 2000 to 1 January 2023 in the PubMed advanced search database. Results: A total of 1015 articles were initially pulled from the PubMed database, and, after a screening process, 21 articles were included in our review. Nineteen of the articles focused on adult populations or families and two focused on children. The main outcomes assessed were changes in self-reported dietary intake, while a few of the articles addressed feasibility and cost-related outcomes. Conclusions: More research is needed to assess whether nutritional interventions to address food insecurity as a social determinant of health are feasible and more cost effective in the long term. Additionally, more work should be conducted in pediatric populations, which could have a robust return on investment in terms of both healthcare utilization and healthcare expenditure.

Understanding food insecurity risk in the United States: A longitudinal analysis

“…Food insecurity, lack of consistent access to the food needed for an active, healthy life, is understood to be a major threat to public health, associated with, among other conditions, greater prevalence of cardiometabolic disease and its complications, worse mental health and health-related quality of life, and greater short-term mortality risk ( Coleman-Jensen, Rabbitt, Gregory, & Singh, ; Berkowitz, Berkowitz, Meigs, & Wexler, 2017 ; Crews et al, 2014 ; Seligman & Berkowitz, 2019 ; Seligman & Schillinger, 2010 ; Gundersen & Ziliak, 2015 ; Te Vazquez, Feng, Orr, & Berkowitz, 2021 ; Hanmer, DeWalt, & Berkowitz, 2021 ; Berkowitz, Palakshappa, Seligman, & Hanmer, 2022 ; Arenas, Thomas, Wang, & DeLisser, 2019 ; Walker et al, 2019 ; Banerjee, Radak, Khubchandani, & Dunn, 2021 ; Gundersen, Tarasuk, Cheng, de Oliveira, & Kurdyak, 2018 ). Further, food insecurity is increasingly a target of interventions, based both within healthcare and outside of it, which seek to improve health ( Seligman & Berkowitz, 2019 ; De Marchis et al, 2019 ; Norris, Jilcott Pitts, Reis, & Haynes-Maslow, 2023 ; The Aspen Institute ). Reducing food insecurity is both a Healthy People, 2030 goal and a UN Sustainable Development Goal ( Healthy People, 2030 ; Food and Agriculture Organization of the United Nations ).…”

Characterizing Healthy Dietary Practices in Japan: Insights from a 2024 Nationwide Survey and Cluster Analysis

“…Consequently, improving dietary habits and experiences has gained significant attention as an effective intervention for preventable health risks, both mentally and socially. While meta-analyses have confirmed the potential effectiveness of health intervention strategies such as taxing fructose beverages [7], improvements in the food environment through retail display signage and vending machine pricing adjustments [8,9], and enhancements in public dining facilities, including school cafeterias, workplace dining, restaurant menus, and vending machine product offerings [10,11], the majority of these studies are based on evidence from Western contexts, highlighting a gap in geographical universality, such as in Japan and Asia.…”

Narrative review: food as medicine across the pediatric age continuum

“…As such, FAM interventions benefit from partnerships between healthcare providers, clinic staff, and Community-Based Organizations (CBO). Food delivery FAM interventions (MTM, MTG, and PRx) addressing food insecurity have been associated with positive clinical outcomes and healthcare utilization and cost in adults, but data regarding these FAM interventions in pediatric populations are limited [ 48 ▪ ].…”