(P12-33-26) How is U.S. Food Insecurity Related to Dietary Quality? A Scoping Review to Inform Nutrition Security Across the Lifespan

Objectives: The relationship between food security (FS) and dietary markers (DM) (e.g., dietary quality, nutrient adequacy and moderation components), across life stages remains incompletely understood, limiting the design of targeted interventions. This scoping review summarized evidence on the relationship between FS level and DM, informing the concept of nutrition security, across U.S. populations.

Methods: PRISMA ScR guidelines were followed. PubMed, CINAHL, Scopus, Embase, and CAB Abstracts were searched for U.S.-based, English-language studies examining FS and DM in free-living, disease-free populations, excluding COVID-19-era research. Two reviewers independently screened records in Covidence, resolving discrepancies with a third reviewer. The % of studies evaluating >2 FS levels was determined. DM were grouped into 3 domains: dietary components (9 components), nutrients (16 components), and bioactives (2 components), and the % of studies with significant differences by FS level out of the total studies within each domain was derived.

Results: Of 1,069 records, 78 met full-text eligibility. Among these, only 12% evaluated DM across >2 FS levels and 88% included 2 FS levels. Among adults, significant differences by FS were observed in 67% of assessed dietary components (6 out of 9 components), 50% of nutrients (8 out of 16), and all tested bioactive compounds (100%; 2 out of 2). In children, differences were observed in all dietary components (100%; 9 out of 9) and in 29% (2 out of 7) of nutrients examined by FS level. Adolescents had fewer differences in DM by FS level than children and adults. Evidence on infants, pregnant women and older adults were limited with no studies for lactating women. Overall, food insecurity was associated with poorer dietary intake and higher intake of moderation components (e.g., saturated fat) across U.S. populations.

Conclusions: Poorer diet quality, lower nutrient adequacy, and higher intake of nutrient-poor foods were linked with food insecurity across most U.S. life-stages. Evidence remains limited for some subgroups and few studies examined multiple FS levels. Filling these gaps is critical to guide targeted interventions to improve nutrition across the lifespan and the concept of nutrition security.

Funding Sources: Purdue Office of Research and the College of Health and Human Sciences at Purdue University