New Tool Validates ‘Nutrition Security’ as Key to Public Health, Beyond Just Food Access
A new screening tool promises to reshape how America understands and addresses healthy eating, moving beyond simply whether people have enough food to whether they have access to nutritious food. Validated in a study involving over 20,000 adults, the Nutrition Security Screener (NSS) identifies specific barriers to obtaining and consuming a healthy diet, offering a more nuanced approach to tackling diet-related diseases.
The NSS, developed by researchers at the food is Medicine Institute at the gerald J. and Dorothy R.Friedman School of Nutrition Science and Policy in collaboration with Kaiser Permanente and the Los Angeles County Department of Public Health, complements existing measures of food security.While food security focuses on resource limitation
“Americans do not eat enough nutritious foods,” explained a senior researcher involved in the study. “Diet-related diseases are a leading cause of suffering, death, and preventable health care costs-we need to understand the specific challenges different people and communities face to achieving a healthy diet.”
The timing of this research is especially significant. For over three decades, the USDA’s Household Food Security reports served as the national standard for tracking food hardship. However, with the recent discontinuation of these reports, a critical data source has been lost, highlighting the urgent need for option measurement tools.
The NSS is designed to fill that gap, offering a complementary approach to food security screening already utilized by healthcare and community organizations. By pinpointing specific barriers, the tool can inform targeted strategies across healthcare, government, and community sectors.
Published in The American Journal of Clinical Nutrition, the study revealed that nutrition insecurity only moderately overlaps with food insecurity. This suggests that many individuals, even those who are food secure, still struggle to consistently access healthy foods.
Perhaps more importantly, researchers found a strong, autonomous link between nutrition insecurity and a range of chronic health conditions – including diabetes, obesity, hypertension, high cholesterol, heart disease, and stroke – even after accounting for food security status and demographic factors. Individuals identified as nutrition insecure also reported poorer physical and mental health.
The barriers to nutrition security are multifaceted. While the high cost of healthy foods was the most frequently cited obstacle – reported by up to 81% of respondents – other significant challenges included a lack of knowledge about healthy eating, time constraints related to shopping and cooking, difficulties adapting traditional foods to healthier preparations, and limited availability of nutritious options in local stores.
“These results highlight that for many Americans, the barriers to healthy eating are complex and extend beyond affordability alone,” said hope Craig, a doctoral candidate and the study’s first author.
The research underscores the value of assessing both food and nutrition security to gain a comprehensive understanding of food access. Individuals experiencing both food and nutrition insecurity exhibited the highest rates of diet-related chronic diseases.
“By identifying who has difficulty accessing healthy food and why, the NSS equips health care providers, public health officials, and policymakers with the details needed to better tailor interventions that seek to address the pathways connecting food and nutrition to health and close gaps in health disparities in the U.S.,” stated a lead researcher.
Potential interventions range from expanding federal nutrition programs and “food is medicine” produce prescriptions for those struggling with cost,to offering culinary education for those lacking cooking skills,and providing support for individuals with physical limitations or inadequate kitchen equipment.
The study’s authors advocate for integrating nutrition security considerations alongside existing food security efforts to improve public health outcomes. As chronic diseases linked to poor diets continue to rise, tools like the NSS offer a vital pathway to identifying at-risk populations and implementing effective, targeted solutions for improving nutrition and health nationwide.
This work was supported by the National Institutes of Health (grant 2R01HL115189-10), the National Science Foundation (S&CC-IRG Award 2125616), the Kaiser Permanente East Bay Community Fund, the Kaiser Permanente National Social Health Practice Office, the Bia-Echo Foundation, the HAND Foundation, and the Seeding the Future Foundation. Complete information on authors, funders, methodology and conflicts of interest is available in the published paper.
