Income and food insecurity: Impact on diet quality and micronutrient intakes of females living in the United Kingdom.

Thomas, Michelle (2023) Income and food insecurity: Impact on diet quality and micronutrient intakes of females living in the United Kingdom. PhD thesis, University of Nottingham.

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Food insecurity in the UK is amongst the worse in Europe and was increasing before the COVID-19 pandemic and continues to increase as the UK is in the midst of a “Cost of Living Crisis”. Research has shown those at risk of food insecurity are more likely to be from low-income households, to be female, have children, have disability or are from ethnic and racial minorities. However, the monitoring of food security in the UK is in its relative infancy, it was not until 2019 that the USDA 10 question adult food security module was introduced into the Family Resource Survey, the first time all four nations of the UK food security was measured in private households.

The research in this thesis is primarily concerned with the prevalence and severity of food insecurity amongst different population groups in the UK at a time when there was disruption to individual’s lives because of the COVID-19 pandemic and their ability to access food. Food access in terms of this research is defined as having the financial resources to purchase food. Furthermore, this research expands on the experience of food insecurity to understand the nutritional security of females in the UK and if there are differences in diet, diet quality and micronutrient intakes between income groups.

Whist understanding who is at the risk of food insecurity is of importance so too is nutritional security, research is needed to understand the contribution of different foods to energy and nutrient intakes amongst food insecure households and not just the quantity of food consumed. Diet is a factor in development of preventable diseases, and it is known a social gradient in diet and health exists. Food related ill health is costly to the individual and to society. The increasing prevalence of food insecurity in the UK is a public health concern, and diet and health inequalities are likely to widen disproportionately impacting those more likely to experience food insecurity and females in particular as they have higher physical requirement for some vitamins and minerals compared to males and when entering the child bearing years with inadequate levels of some minerals, this can negatively impact the growth and development of future generations.

As such, this researched focused on the nutritional security of adolescent girls and adult women because 1) the experience of food insecurity is associated with high rates of poverty, previous research indicates females are disproportionately represented in low income groups compared to men (Maynard et al., 2018). 2) Adolescent females have a higher requirement for iron compared to males from the age of 11 years onwards. Iron requirements are increased to support growth and development at this life stage in both males and females however there is a need to compensate for the loss of iron due to menstruation in females. Zinc requirements are higher for 11–14-year females compared to 15-18 years to support increased physiological requirements at this life stage 3) Previous studies show adult women have lower intakes but higher requirement for some micronutrients compared to males (e.g., iron). A previous study showed riboflavin, iron and iodine intakes amongst females to be lower compared to males (Derbyshire, 2018).

The two published manuscripts and the manuscript in preparation for submission provide a unique contribution to the knowledge of food security and nutritional insecurity in the UK amongst different population groups. Whilst adolescent females are represented within national surveys, analysis of equivalised household income influence on diet and nutrient intakes are not fully explored. Adolescents is a time when there is greater autonomy in food choice and whilst this may explain some of the differences in diet and nutrient intake, food choice is also influenced by caregivers/ parental choice, which is in, part is influenced by the income available to spend on food. Manuscript 2 took place at a time when the UK and indeed the world were amid the COVID-19 pandemic, and as such, research into food and nutritional insecurity in the UK at this time was a burgeoning area. The study set out to understand the impact of the Covid-19 Pandemic on food and nutritional security across the income spectrum and if those with a lower equivalised household income were disproportionally impacted at a time when UK food retailers were unable to keep pace with consumer demand and movement restrictions were enforced.

Study 3 expanded on paper two seeking to understand the Food and Nutritional security amongst those with an income from Universal Credit and the influence and subsequent removal of the £20 a week uprating to Universal credit has on foodbank usage and food purchase. The novelty of the study was in its targeting to population groups across England, Scotland and Wales with an income from Universal Credit. Historically households with income from benefits in National Surveys are not fully representative and as such, sub-analysis of the data is not always possible due to the small sample sizes. Combined, the three cross sectional studies in this thesis find adolescent girls and adult women in the UK have a poorer diet quality, micronutrient intakes, which are low, compared to the RNI and a high percentage with dietary micronutrient intakes below the LRNI. The diets of lower income adolescents and adult women do not meet the criteria for food and nutritional security, as they do not have diet with sufficient quantity of nutritious foods. In general, the studies found a gradient in micronutrient intakes and diet quality when categorised by equivalised household income. This work has highlighted the nutritional security of low income and food insecure female adolescents and adults to be poor when compared to their higher income and food secure counterparts. Highlighting the need for targeted interventions to address both food and nutrition insecurity in the UK.

Item Type: Thesis (University of Nottingham only) (PhD)
Supervisors: Welham, Simon
Coneyworth, Lisa
Azam-Ali, Sue
Keywords: food insecurity, food security, diet, nutrition, women, adolescents, COVID-19, pandemic
Subjects: R Medicine > RA Public aspects of medicine > RA 421 Public health. Hygiene. Preventive Medicine
T Technology > TX Home economics
Faculties/Schools: UK Campuses > Faculty of Science > School of Biosciences
Item ID: 76935
Depositing User: Thomas, Michelle
Date Deposited: 13 Dec 2023 13:48
Last Modified: 13 Dec 2023 13:50

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