Infant Food Security in New Zealand: A Multidimensional Index Developed from Cohort Data

Abstract

Food security (FS) during infancy is associated with lifelong outcomes. New Zealand is a developed economy that reports poor childhood nutrition-related health statistics, particularly among minority children, yet has no measure of FS applicable to infancy. The objective was to develop an FS index for New Zealand infants and examine its association with demographic covariates and health outcomes. Within a large (n = 6853) nationally representative cohort, variables describing infant food consumption, breastfeeding, and maternal food-related coping methods were collected from mothers during late infancy. An FS index was derived using confirmatory factor analysis. Associations were assessed by logistic regressions and described using odds ratios (OR) and ≥95% confidence intervals (CI). Fifteen percent of the cohort was highly FS, 43% tenuously food insecure (FIS), and 16% highly food insecure (FIS). Infants from minority ethnic groups had lower odds of being food secure, as did those born to the youngest mothers, mothers who smoked, or those who lived in low-income households. FIS infants had higher odds of morbidity. Interventions to improve infant FS should focus on improving dietary quality, and should give particular consideration to minority infants. We identified that FIS shows wide ethnic and socioeconomic inequity, and is associated with poorer health. The most important driving factors of FIS included poor quality weaning diets, as well as poverty and its proxies. Any interventions to improve infant FS should focus on increasing fruit and vegetable consumption to recommended intake levels, and should give particular consideration to minority infants.

Modifiable Early Childhood Risk Factors for Obesity at Age Four Years

“…32 The index is created using variables describing: exclusive breastfeeding to age 3 months and, at age 9 months, consumption of sentinel foods (e.g., grains, legumes and nuts, flesh foods, eggs, fruits, and vegetables); consumption of energy-dense nutrient-poor foods, and maternal coping methods around food related to material hardship. 32 The food security index score ranged from 0 to 49.29, with a higher score indicating higher food security. Table 1 displays this score as quartiles to look at the distribution among children with and without obesity.…”

Ecological Analysis of Stunted Toddler in Indonesia

“…This is in line with the basic concept of growth and development which states that socio-economic factors are variables that have an influence on the quality of growth and development 13,14 . The poverty factor is considered to be closely related to family characteristics such as education level, purchasing power so that it will affect family access in the search for health services, providing quality food and also providing a clean and healthy environment 15,16 .…”

Food Security and Diet Quality in Native Hawaiian, Pacific Islander, and Filipino Infants 3 to 12 Months of Age

“…It is considered a high priority for public health stakeholders given its economic and health impacts and the associated nutritional risks [1]. These impacts include worse developmental outcomes and chronic illness among children [2], and poorer health outcomes in infants [3]. Situations of food insecurity are linked with disrupted eating patterns, poor diet quality and nutritional inadequacy across age groups and demographics [4].…”

“…Situations of food insecurity are linked with disrupted eating patterns, poor diet quality and nutritional inadequacy across age groups and demographics [4]. Infants aged 0-12 months are more susceptible to the adverse effects of food insecurity given their high nutritional requirements for growth and dependence on others for nutrition [3]. Optimal nutrition during infancy protects against morbidity and mortality, reduces the risk of chronic disease, and promotes better overall development, and thus efforts to understand and mitigate nutritional risks such as infant food insecurity and improved nutrition in early life may have far-reaching implications [5].…”

“…An eighteen-item survey known as the U.S. Household Food Security Survey Module (USHFSSM) was developed by the United States Department of Agriculture (USDA) to assess household food security; a portion of the survey questions may be used to determine the food security of a child or children within the household [6]. In contrast to this method, Schlichting D. et al devised a food security index which aims to assess the food security of an infant at an individual level within a household [3]. In addition to food security status, another indicator of nutritional risk is household income as it is theorized that some low-income households lack economic access to healthy foods [7,8].…”