Food insecurity is the condition of inconsistent or uncertain availability of safe and nutritionally adequate food^{1, 2}. Food insecurity is associated with poor diet quality, weight gain, diabetes and hypertension among adults. Current research suggests that the availability of fruit and vegetables (F&V) in the home is positively associated with daily intake of F&V; this environment where a variety of F&V are available would be considered a positive home food environment^3,4. Studies have shown that food insecurity significantly affects the availability of a variety of foods; more specifically, food insecurity is associated with lower availability of F&V and higher availability of energy-dense processed foods^4,5. The interrelationship between food security status, dietary behaviors, and the home food environment has not yet been investigated.

This study was conducted to assess the food security status, availability of F&V, and dietary behaviors of a group of low-income pregnant women who are at an increased risk of weight gain during pregnancy due to poor dietary habits. The first objective of this study was to determine the differences in availability of F&V at home by food security status. The second objective was to examine the relationships between food security status, availability of F&V at home, and intake of F&V among lowincome pregnant women.

198 low-income pregnant women participated

Pregnant women in their second trimester attending the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) clinic were invited to participate in this study (n = 198). During wait times of their maternity appointment at the WIC clinic, women participated in a structured interview where information was collected on F&V: their availability in the home, the variety available, the frequency of consumption and food security status.

Food Security and daily F&V intake

Of the participants, 38% reported full food security, 19% reported marginal food security, 24% of participants reported low food security, and 19% of participants reported very low food security. The mean daily intake for fruit was 1.76 servings (SD 1.23) per day, and the mean daily intake for vegetables was 1.88 servings (SD 1.22) per day.

Variety of available F&V at home by food security level

Among the study participants, the average number of different types of F&V available in the home was 8 types of fruit and 12 types of vegetables. Results revealed that the participants with very low food security had significantly lower variety of fruit available in the home compared to fully food secure participants; this finding was mirrored in the variety of vegetables available in the home for very low versus fully food secure, but the finding was marginally significant.

Associations between food security status, variety of F&V available, and F&V intake

Food security status did not predict daily fruit or vegetable intake. However, food security significantly predicted the variety of available F&V. When food insecurity increased, the variety of available fruit decreased. Additionally, a one-unit increase in the variety of available fruit was associated with a 0.086 increase in daily fruit intake and the total variety of available vegetables was positively associated with daily vegetable intake.
Mediation analyses indicated that through the availability of variety of fresh F&V at home, there was an association between food security status and the daily intake of F&V. As food security worsened, a decline in the available variety of fresh F&V was observed, which was associated with lower intake.

Study implications and conclusions

Several points should be highlighted:

1. There is a risk of over- or underrepresenting certain population groups because a convenience sampling technique was used to recruit participants. Although, the demographic characteristics of our sample were closely representative of county and state demographics of low-income women.
2. The frequency of daily intake of F&V was measured and is not reflective of quantity of intake.
3. The specificity of the results is limited due to measuring only the availability of variety of F&V, without measuring specific amounts and at what frequency they are available.
4. Generalizability of the results among low-income pregnant women may be reduced due to restricting recruitment to WIC pregnant women.

Food security, home food environment, and diet quality are interlinked. The home environment and food security play important roles in influencing availability and intake of fresh F&V at home. The results from this study indicate the need for nutrition education interventions for low-income families to promote the availability of healthy options at home and improve nutritional outcomes.

Based on : DL Nunnery, JD Labban, & JM Dharod. (2017). Interrelationship between food security status, home availability of variety of fruit and vegetables and their dietary intake among low-income pregnant women. Public Health Nutrition, 1-9. https://doi.org/10.1017/S1368980017003032