Objectives: Standardized guidelines and reference points for a food security policy are necessary to guarantee that basic social safety nets work properly. Therefore, this study aimed to explore the basic concepts and detailed dimensions of food security, including the potential relevant indicators, and sought to establish standardized well-being baselines. Methods: A literature review and 14 expert roundtable discussions were carried out to analyze and extract the key concepts of food security. After determining these concepts and detailed dimensions of food security, a conceptual framework was modeled. Then, indicators for each local government that could be monitored and evaluated for each sub-area were suggested. Results: The concept of food security was defined as follows: Individuals should be provided with sufficient, safe, and quality food, which should be accessible to the community and available for use to achieve health and well-being. In addition, food security should be ensured sustainably in a changing environment. Four dimensions were suggested while conceptualizing food security. First, sufficient food, which means sufficient food supply in quantity, quality, and safety. Second, equitable food which includes creating environments in which high-quality and safe food can be purchased at an appropriate price and can be provided regardless of the socioeconomic gap. Third, healthy food which should be provided to promote people's health and happiness through the eco-friendly consumption of food. Fourth, sustainable food, which can be supplied in a sustainable manner and as part of an eco-friendly food system that considers the conservation of natural environments. Conclusions: The basic concepts and detailed areas of food security including the potential indicators proposed in this study, may be useful for developing and implementing various policies and programs to support food and nutrition security in the future.
Given that household food security issues have become the concern of the Korean society, this study aimed to develop food security measures for the Korean population. Based on the literature reviews on previously developed food security measures, the 18-item US household food security survey module (US HFSSM) was adapted. The developed food security measures was assessed by qualitative validity method. It was evaluated and modified by face validity by expert focus groups belong to university, public health center, and government agencies and by cognitive interview by 40 subjects with low household income who live in an urban community and are participants in welfare programs of local districts. Then, it was reviewed and revised by the National Institute of the Korean Language and the advisory committee for nutrition survey of Korean National Health and Nutrition Examination Survey (KNHANES). The results showed that the developed questionnaire items were well adapted by expert focus groups and general subjects, showing the feasibility of measuring food security with the developed measures although there were discrepancies in some expressions of questionnaire items between experts focus groups and general subjects. The study to assess reliability and quantitative validity of the developed food security measures should be further needed to examine its application for KNHANES.
The objective of this study was to assess the reliability and validity of food security measures, which was developed based on the US household food security survey module (US HFSSM) with content validity in the Korean population. The reliability and validity were assessed by internal consistency, construct validity and criterion-related validity. The study included 446 households. Among those, 46.2% were households with children. The proportion of food insecure households was 33.3%. Among those, 35.4% and 64.6% households were food insecure with hunger and without hunger, respectively. The Cronbach's alpha coefficients were 0.84 and the infit value by the Rasch model analysis ranged from 0.68 to 1.43. The scale item response curves by food insecurity severity explained well the nature and characteristics of food security, indicating the highest proportion of "yes" for the items on diet quality, followed by those with diet quantity. The result of criterion-related validity showed that food insecurity status was significantly related in a dose-response manner with the household income level, food expenditure, subjective health state, subjects' educational level. Household food security status was also related to dietary diversity regarding protein foods, fruits and fruit juice, and milk and dairy product. These findings suggest that the food security instrument is reliable and valid and would be used to assess food security status in the Korean population.
BACKGROUND/OBJECTIVES: North Korean refugees (NKRs) in South Korea are a unique population as they must adapt in a new country with similar cultural traits but different social, political, and economic systems, but little research has been conducted on diet and nutrition in this population. This study examined food security, dietary behaviors, and nutrient intakes among adult NKRs living in South Korea and compared them to those of South Koreans. SUBJECTS/METHODS: The subjects were 139 adult NKRs (25 men, 114 women) living in the Seoul metropolitan area, and 417 age- and sex- matched South Korean controls (SKCs; 75 men, 342 women) selected from the Korea National Health and Nutrition Examination Survey (KNHANES). Food security and dietary behaviors (meal skipping, eating-out, meals with family, nutrition education and counseling, and nutrition label knowledge and utilization) were obtained using self-administered questionnaires. Nutrient intakes were assessed by 24-hr recall. The statistical analysis was performed using IBM SPSS ver. 23.0. RESULTS: In South Korea, food security had improved over the previous 12 months, but remained significantly poorer for NKR women than SKC women. Meal skipping was three times more frequent than for SKCs and eating-out was rare. Average energy intake was 1,509 kcal for NKR men and 1,344 kcal for NKR women, which was lower than those of SKCs (2,412 kcal and 1,789 kcal, respectively). Significantly more NKRs (men 24.0%, women 21.9%) showed simultaneously deficient intake in energy, calcium, iron, vitamin A, and riboflavin than SKCs (men 2.7% (P = 0.003), women 7.0% (P < 0.001)). NKR women had a significantly higher index of nutrient quality (INQ) for some nutrients than SK women. CONCLUSIONS: This study reports significant differences in food security, dietary behaviors, and nutrient intakes between NKRs and SKCs. Generally, NKRs reported lower intakes despite improved food security, but relatively good INQs across nutrients. Further research is needed to understand processes of food choice and consumption among NKRs to provide appropriate support aimed at improving diets.
Janice Ee Fang Tay;Satvinder Kaur;Wui Wui Tham;Wan Ying Gan;Nik Norasma Che Ya;Choon Hui Tan;Serene En Hui Tung
Nutrition Research and Practice
/
제17권2호
/
pp.269-283
/
2023
BACKGROUND/OBJECTIVES: This study aimed to examine the food security status of urban poor adolescents and its association with diet quality. SUBJECTS/METHODS: A cross-sectional survey was conducted among 188 adolescents aged 13-18 yrs living in Kuala Lumpur, Malaysia. Household food insecurity and dietary intake data were collected using the Radimer/Cornell hunger and food insecurity instrument and 2-day 24-h dietary recalls, respectively. Diet quality was determined using the Malaysian Healthy Eating Index (HEI). Weight and height were measured and body mass index-for-age, as well as height-for-age z scores were calculated. RESULTS: The present study revealed that 47.9% of the adolescents experienced household food insecurity, 24.5% experienced individual food insecurity, 18.6% household food security, and 9.0% child hunger. The mean score of diet quality was 56.83 ± 10.09, with a significantly lower HEI score among food insecure adolescents (household food insecure, individual food insecure, and child hunger) than household food secure adolescents (P = 0.001). The differences between food secure and food insecure households were found to be significant for energy (P = 0.001) and nutrients including proteins (P = 0.006), carbohydrates (P = 0.005), dietary fiber (P = 0.001), folate (P < 0.001), and vitamin C (P = 0.006). The multiple linear regression showed that adolescents who experienced food insecurity (β = -0.328; P = 0.003) were found to be significantly associated with poor diet quality (F = 2.726; P < 0.01), wherein 13.3% of the variation in the diet quality was explained by the food security status. CONCLUSIONS: Experiencing food insecurity contributed to poor diet quality among urban poor adolescents. Further longitudinal studies are needed to comprehensively understand this association to improve food insecurity and diet quality among urban poor communities.
BACKGROUND/OBJECTIVES: Food shortage situation in North Korea has gained much interest, however food insecurity caused by the food shortage in North Korean households has not been much investigated. This study examined food security experiences and food consumption pattern of displaced North Korean households currently living in South Korea. SUBJECTS/METHODS: Food security experience among 51 North Korean households living in South Korea was examined using the Household Food Insecurity Access Scale (HFIAS) in three time points: immediately before childbirth, immediately before leaving North Korea, and immediately before entering South Korea. Meal/snack consumption frequencies and food diversity were also examined. RESULTS: Food security situation was the worst at the time of immediately before leaving North Korea with the average HFIAS score of 10.05. The households that were food insecure, they tended to be "severely" insecure. Although majority of the subjects reported having three or more meals a day, food diversity in their diet was very low with the average food diversity score of 2.17 immediately before childbirth and 1.74 immediately before leaving North Korea. Their diet appeared to heavily rely on grain and vegetable. CONCLUSIONS: This study is one of few that specifically examined food security of North Korean households with a pre-developed scale, and that demonstrated food security situation at different time points in quantified terms. Replicating this study with different groups of North Korean households for different time points would allow more complete understanding of impacts of food shortage. Food diversity score could provide a good way to examine changes of food consumption occurring to North Koreans in the process of adaptation. More attention to the changes occurring during adaption to South Korea should be given to understand the process and impact and to prepare public nutrition policy for the re-unified Korea.
BACKGROUND/OBJECTIVES: This study aimed at evaluating the dietary intakes of Korean adolescents affected by food insecurity, in comparison with those who were food secure. SUBJECTS/METHODS: The study used one day 24-hour dietary recall data from the $6^{th}$ Korea National Health and Nutrition Examination Survey. The study subjects consisted of 1,453 adolescents of whom 695 were middle school-aged and 758 were high school-aged. Food security status was assessed using the 18-item questionnaire. Nutrient intake was evaluated in terms of nutrient density, insufficient intake, and excessive intake for selected nutrients, in addition to meeting the appropriate range for total energy intake and energy intakes from carbohydrate, sugar, protein, fat, and saturated fatty acids. Food intake was evaluated in terms of food group servings and dietary diversity score (DDS). RESULTS: The percentages of food insecurity were 11.1% for middle school-aged adolescents and 16.8% for high school-aged adolescents. Food insecure middle school-aged adolescents had higher intake of carbohydrate (P = 0.006) but lower intake of fat (P = 0.010) and saturated fatty acids (P = 0.005) than their food secure counterparts although the intake of both groups was in the recommended ranges. Nutrient intake among high school-aged adolescents was generally similar regardless of food security status. Both food secure and insecure adolescents showed insufficient intake of vitamin A, vitamin C, and calcium, and excessive sodium intake. They additionally had low prevalence of meeting appropriate intake ranges for energy, carbohydrate, and sugar. Food intake in terms of food group servings and DDS was also similar regardless of food security status among both age groups, with low intakes of foods from fruit and dairy groups. CONCLUSIONS: Except for a few nutrients among the middle school-aged adolescents, dietary intakes among Korean adolescents did not differ by food security status in this study.
This study was a qualitative investigation into the food security and food variety among the rural elderly. For the qualitative data collection, nineteen elderly people who lived in Yangpyeong-gun were interviewed individually. Food security and variety was evaluated based on accessibility and affordability. The participants seemed to have difficulty preparing their own meals and eating with their families or others. The frequency of vegetable intake was found to be high, as vegetables were available through cultivation. However, in terms of diversity, the intake of meat and milk, which are sources of protein and calcium, was found to be significantly low. This has to do with very poor physical accessibility. A lack of nutrition education was identified as the biggest reason for not following dietary therapy despite having a pre-existing disease condition. Therefore, for the elderly in Yangpyeong-gun, it is suggested that a basic nutrition policy for food supply that can increase their actual intake is more essential than education on cooking and nutrients. Moreover, periodic nutrition education or a regular counseling system for dietary therapy through local public health centers may help improve the health of the elderly.
Objectives: This study was performed to investigate the associations of food security with socio-demographic characteristics, nutrient intakes and mental health status among older Korean adults. Methods: This study was conducted using data from the 2008-2010 Korea National Health and Nutrition Examination Survey (KNHANES). Subjects were 4,451 adults aged 65~98 years. Food security was measured using a self-reported question on food sufficiency of subjects' household. Based on the answers, study subjects were classified into secure, mildly insecure, moderately insecure, and severely insecure groups. Dietary intake was estimated by 24-hour dietary recall. Nutrient intake was assessed by dietary reference intakes (DRI). As for mental health status, the data on mental stress, depression, and suicide ideation were used. Results: Rate of food insecurity in older adults was 14.3%. Old age, being female, low education, low income level, living alone, and discomfort in daily living were more related to food insecurity. Means of nutrient intakes were significantly different according to food security status. Intakes of calcium, potassium, and vitamin $B_2$ were lower than recommended intakes in all groups. Consumption amounts of soy and soybean products, vegetables, mushrooms, fruits, vegetable oils, meats, eggs, seafood, and dairy products were lower in food insecure groups. Mental stress, depression, and suicide ideation were higher in food insecure groups independent of the gender and income level. Conclusions: These present findings suggested that food security is related to mental health as well as nutrition status in older Korean adults. A national system that include food and psychosocial support programs for the elderly should be considered in order to improve the overall health of older Korean adults.
Coordination has been identified as a concern in the cross-cutting issues of food security and nutrition (FSN) in Cambodia. Food Security and Nutrition Information System (FSNIS) in Cambodia is the only "entry portal" to support policy formulation and decision-making with regard to FSN. While this knowledge and information management system has earned a respectful reputation, Council for Agricultural and Rural Development (CARD) faces many challenges in the implementation of the system. This paper will present how FSNIS has been developed and impacts on policy or strategy related to FSN. In addition, sustainability of the system is a key challenge for FSNIS; yet it is interesting to see how it works. Along with a success story, FSNIS is recognized by its stakeholders as the most successful knowledge and information management system in the field of FSN in Cambodia.
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