Division of Gastroenterology and Hepatology, Department of Medicine, University of Calgary, Calgary, Alberta, Canada.
Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Am J Gastroenterol. 2021 Mar 1;116(3):584-592. doi: 10.14309/ajg.0000000000001118.
Food insecurity is associated with negative nutritional outcomes and is experienced differently by women vs men. We evaluated the effects of gender on food insecurity and dietary intake in the United States.
Data from the National Health and Nutrition Examination Survey (2007-2016) were analyzed. Survey-weighted linear and logistic regression models were used to evaluate predictors of food security and the effect of food security on dietary consumption and body anthropometrics. Gender was modeled as a covariable and as an effect modifier.
A total of 30,251 respondents were included. Approximately 15.1% (95% confidence interval [CI]: 14.1%-16.1%) of participants were food insecure. This increased over time from 11.7% in 2007-2008 to 18.2% in 2015-2016. A higher proportion of women experienced food insecurity compared with men (53.3% vs 46.7%, P = 0.02), although this was not significant after adjusting for poverty and other confounders (adjusted odds ratio 1.01; 95% CI: 0.93-1.09; P = 0.81). Among food insecure women, 32.4% (95% CI: 30.0%-34.9%) received emergency food assistance and 75.0% (95% CI: 71.5%-78.2%) received supplemental nutrition assistance benefits. Relative to men, food insecure women were less likely to meet the recommended dietary allowance of most macronutrients and micronutrients. They were also significantly more likely to be obese, have a wider waist circumference, and have higher total body fat percentage (P interaction all <0.001).
Food insecurity represents a substantial public health challenge in the United States that differentially affects women compared with men. Alternative strategies may be required to meet the nutritional requirements for food insecure women.
食物不安全与负面营养结果有关，并且女性和男性的体验方式不同。我们评估了性别对美国食物不安全和饮食摄入的影响。
分析了来自国家健康和营养检查调查（2007-2016 年）的数据。使用调查加权线性和逻辑回归模型来评估食物安全的预测因素，以及食物安全对饮食消费和身体人体测量的影响。性别被建模为协变量和效应修饰剂。
共有 30251 名受访者。约有 15.1%（95%置信区间[CI]：14.1%-16.1%）的参与者食物不安全。从 2007-2008 年的 11.7%到 2015-2016 年的 18.2%，这一比例呈上升趋势。与男性相比，更多的女性经历了食物不安全（53.3%比 46.7%，P=0.02），尽管在调整贫困和其他混杂因素后，这并不显著（调整后的优势比 1.01；95%CI：0.93-1.09；P=0.81）。在食物不安全的女性中，32.4%（95%CI：30.0%-34.9%）接受了紧急食品援助，75.0%（95%CI：71.5%-78.2%）接受了补充营养援助福利。与男性相比，食物不安全的女性更不可能满足大多数宏量营养素和微量营养素的推荐膳食允许量。她们也更有可能肥胖，腰围更宽，体脂百分比更高（所有 P 交互<0.001）。
食物不安全在美国是一个重大的公共卫生挑战，对女性的影响与男性不同。可能需要采取替代策略来满足食物不安全女性的营养需求。
