The overall aim of this thesis was to gain a clearer picture of the prevalence of food insecurity in the Netherlands and its consequences for dietary quality and health. The studies included in... Show moreThe overall aim of this thesis was to gain a clearer picture of the prevalence of food insecurity in the Netherlands and its consequences for dietary quality and health. The studies included in this thesis provide potential targets for interventions aimed at reducing food insecurity among affected people and families in the Netherlands.Based on this thesis, we can conclude that a considerable number of people in the Netherlands experience food insecurity. The findings described in this thesis provide insight into the consequences: food insecurity is associated with obesity, poor physical and mental health, and poor dietary quality. Our results also illuminate the role of sociodemographic and lifestyle factors, psychosocial factors and the food environment in these associations. In addition, our findings offer a clearer understanding of the perceived needs, perceptions and barriers regarding healthy eating among people at risk of experiencing food insecurity, as well as suggesting potential interventions. This thesis has shown that the issue of food insecurity needs to be better recognized and addressed in the Netherlands, for example through the development and implementation of population-based and risk group-based interventions for which appropriate screening and targeted interventions should be further explored. Show less
Velde, L.A. van der; Nyns, C.J.; Engel, M.D.; Neter, J.E.; Meer, I.M. van der; Numans, M.E.; Kiefte-de Jong, J.C. 2020
BackgroundFood insecurity is related to risk of adverse health outcomes such as obesity, but the explanatory factors underlying this association are still unclear. This study aimed to assess the... Show moreBackgroundFood insecurity is related to risk of adverse health outcomes such as obesity, but the explanatory factors underlying this association are still unclear. This study aimed to assess the association between food insecurity and obesity, and to explore potential mediation by sociodemographic and lifestyle factors.MethodsThis cross-sectional study was conducted among 250 participants in a deprived urban area in the Netherlands. Data on sociodemographic and lifestyle factors, food insecurity status and diet quality were collected using questionnaires. Diet quality was determined based on current national dietary guidelines. BMI was calculated from self-reported height and weight. Regression analyses were performed to explore the association between food insecurity and BMI status. Mediation analyses were performed to estimate the total-, direct-, and indirect effect and proportion of total effect mediated of the food insecurity-obesity association.ResultsThe overall prevalence of food insecurity was 26%. Food insecurity was associated with obesity (OR=2.49, 95%CI=1.16, 5.33), but not with overweight (OR=1.15, 95%CI=0.54, 2.45) in the unadjusted model. The food insecurity-obesity association was partially mediated by living situation (proportion mediated: 15.4%), diet quality (-18.6%), and smoking status (-15.8%) after adjustment for other covariates.ConclusionsThe findings of this study suggest an association between food insecurity and obesity. Living situation, diet quality and smoking status explained part, but not all, of the total association between food insecurity and obesity. Future longitudinal studies are warranted to examine the temporal order of the food insecurity-obesity association and potential mediators in this relationship. In addition, food insecurity and its potential consequences need to be taken into account in obesity prevention programs and policies. Show less
