title: Household Food Insecurity Is Not Associated with Overall Diet Quality Among Pregnant Women in NHANES 1999-2008.
abstract: Analyze the association between household food security status and diet quality during pregnancy.
  
  
  
  Cross-sectional analysis of pregnant women from the National Health and Nutrition Examination Survey from 1999 to 2008. Of the 1158 pregnant women with complete household food security information, we analyzed 688 women who had complete dietary information and household incomes ≤300 % of the Federal Poverty Level (FPL). Diet quality was measured by the Alternate Healthy Eating Index modified for Pregnancy (AHEI-P) from 1 to 2 24 h dietary recalls. Multivariate linear and logistic regression models were implemented to assess the association between household food security status and AHEI-P, adjusting for age, nativity, marital status, race/ethnicity, education, and household income.
  
  
  
  Among women with household incomes ≤300 % of the FPL, 19 % were food insecure and 4 % were marginally food secure. The mean AHEI-P score was 41.9 (95 % CI 40.4, 43.3). Household food insecurity was not associated with overall diet quality. However, living in a food insecure household compared to a food secure household was associated with a 2.3 (1.3, 4.1) greater odds of having a calcium component score greater than the median intake of calcium scores among food secure women in the sample.
  
  
  
  In a nationally representative sample of pregnant women, 80 % lived in a fully food secure household. Improving household food security during pregnancy is a public health opportunity to improve health outcomes; however household food security status may not be associated with overall diet quality.
authors.affiliation: Division of Epidemiology, UC Berkeley School of Public Health, 101 Haviland Hall, Berkeley, CA, 94720, USA. ryangamba@gmail.com.
authors.forename: Ryan
authors.identifier: 0000-0002-7385-2509
authors.initials: R
authors.lastname: Gamba
authors.affiliation: Center for Health and Community, School of Medicine, University of California, San Francisco, 3333 California Street, Suite 465, Campus Box 0844, San Francisco, CA, 94143-0844, USA.
authors.forename: Cindy W
authors.initials: CW
authors.lastname: Leung
authors.affiliation: Division of Community Health and Human Development, Maternal and Child Health Program, School of Public Health, University of California, Berkeley, 207-J University Hall, Berkeley, CA, 94720, USA.
authors.forename: Sylvia
authors.initials: S
authors.lastname: Guendelman
authors.affiliation: Division of Biostatistics, UC Berkeley School of Public Health, 307 Haviland Hall, Berkeley, CA, 94720, USA.
authors.forename: Maureen
authors.initials: M
authors.lastname: Lahiff
authors.affiliation: Division of Public Health Nutrition, School of Public Health, University of California, Berkeley, 207-B University Hall, Berkeley, CA, 94720, USA.
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Laraia
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D004032:Diet; D002149:Energy Intake; D005191:Family Characteristics; D005247:Feeding Behavior; D005260:Female; D005523:Food Supply / Q000706:statistics & numerical data*; D006801:Humans; D015596:Nutrition Assessment; D009749:Nutrition Surveys; D011247:Pregnancy; D037841:Pregnant People; D012959:Socioeconomic Factors; D014481:United States; D055815:Young Adult
keywords: Diet quality; Food insecurity; Maternal nutrition; National Health and Nutrition Examination Survey; WIC