ArticleThe American journal of clinical nutrition2025
Associations between cross-sectional and long-term food insecurity with dietary quality among middle-aged and older US adults: A Cohort Study from the Health and Retirement Study.
Article in The American journal of clinical nutrition, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Food environment and cardiovascular kidney metabolic diseases mortality.NPJ science of food · 2026Article
- How Is U.S. Food-Insecurity Related to Dietary Quality? A Scoping Review to Inform Nutrition Security Across the Lifespan.Nutrients · 2026Article
- Food insecurity, epigenetic age acceleration, and depression in middle-aged and older adults: a longitudinal cohort study.Frontiers in nutrition · 2026Article
- Ultra-processed food intake and impairment across multiple cognitive domains in nationally representative older U.S. adults.Frontiers in public health · 2025Article
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6 authors.
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Abstract
backgroundFood insecurity impedes healthy diet adherence, but few studies, particularly longitudinal studies, have examined these associations in middle-aged and older adults.
objectivesUsing the longitudinal Health and Retirement Study (HRS), we examined the associations between cross-sectional and long-term food insecurity and diet quality among United States middle-aged and older adults.
methodsParticipants aged ≥50 at the time of initial food insecurity assessment and who completed the 2013 Health Care and Nutrition Study (HCNS) were included (cross-sectional food insecurity: n = 6783; long-term food insecurity: n = 4923). Food insecurity was assessed using the 6-item United States Department of Agriculture Food Security Survey Module in 2013. Long-term food insecurity was estimated by averaging 2 items from the 18-item Household Food Security Survey Module assessed biennially (2002-2012). Dietary intake was assessed using a food frequency questionnaire in 2013 to create 5 diet quality indices: the plant-based diet index (PDI), healthful PDI, unhealthful PDI (uPDI), Mediterranean diet index, and Mediterranean-Dietary Approaches to Stop Hypertension Intervention for Neurodegeneration Delay (MIND) diet index. Weighted multivariate linear regression models examined the associations between food insecurity and diet quality indices.
resultsIn cross-sectional analyses, very low food security was associated with higher scores on the uPDI (1.46; 95% CI: 0.45, 2.48) and low food security was associated with lower Mediterranean diet index scores (-0.69; 95% CI: -1.30, -0.09). In long-term analyses, very low food security was associated with lower scores on overall PDI (-1.15; 95% CI: -2.37, 0.08; P-trend = 0.03), Mediterranean diet index (MIND diet index) (-1.33; 95% CI: -2.24, -0.42; P-trend < 0.01), and Mediterranean-Dietary Approaches to Stop Hypertension Intervention for Neurodegeneration Delay diet index (-0.58; 95% CI: -1.00, -0.17; P-trend < 0.01), and higher scores on the uPDI (1.92; 95% CI: 0.15, 3.69; P-trend = 0.01). Associations with health PDI (hPDI) were not significant.
conclusionsAmong adults aged 50 y or older, food insecurity, especially long-term very low food security, is adversely associated with diet quality, highlighting the need for policies to reduce food insecurity and facilitate healthy eating habits.
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