Special Issue "Dietary Behaviors and Health Outcomes in Low-Income Populations"

Special Issue Editor

Dr. Rickelle Richards
E-Mail Website
Guest Editor
Department of Nutrition, Dietetics and Food Science, Brigham Young University, S233 Eyring Science Center, Provo, UT 84602, USA
Interests: food insecurity; low-income populations; homelessness; college students
Special Issues and Collections in MDPI journals

Special Issue Information

Dear Colleagues,

I invite you to consider submitting a paper to a Special Issue in the International Journal of Environmental Research and Public Health (IJERPH) entitled “Dietary Behaviors and Health Outcomes in Low-Income Populations.”

In 2019, the United Nations estimated that 8.2% of people globally were living in poverty and 25.9% were food insecure, with these numbers projected to increase as a result of the COVID-19 pandemic (United Nations Sustainable Development Goals Report, 2020). Previous qualitative and quantitative research has suggested that low-income populations alter dietary behaviors as a result of inadequate income or limited access to food, which in turn has been shown to negatively impact health. Research is needed to further evaluate the dietary behaviors of low-income populations and how this affects health, as a means to better understand the impact of poverty globally and how to best address it.  

Manuscript submissions for this Special Issue may be based on qualitative, quantitative, or mixed methods original research or secondary data analyses (including reviews) that evaluate:

  • Dietary behaviors such as food choices, food access, eating patterns, or other dietary behaviors
  • Health outcomes such as body mass index or other anthropometric measures, diabetes, heart disease or other physical health outcomes, and mental health outcomes (depression, anxiety, etc.)

Low-income populations can include samples from across the life-span, including pregnancy, young children, pre-adolescents, adolescents, young adults or college students, adults, and older adults, and life situations such as homelessness and the use of food assistance programs. Articles related to the impact of the COVID-19 pandemic on dietary behaviors and health outcomes in low-income populations are also welcomed.

Dr. Rickelle Richards
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2300 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.


  • food insecurity
  • poverty
  • homelessness
  • food assistance programs
  • eating patterns
  • food choices
  • food access
  • dietary behaviors
  • physical health outcomes
  • mental health outcomes

Published Papers (1 paper)

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Timing of WIC Enrollment and Responsive Feeding among Low-Income Women in the US
Int. J. Environ. Res. Public Health 2021, 18(14), 7695; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18147695 - 20 Jul 2021
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We examined associations between the timing of The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) enrollment and responsive feeding and assessed food security as a possible effect modifier. We used data from the nationally representative WIC Infant and Toddler Feeding [...] Read more.
We examined associations between the timing of The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) enrollment and responsive feeding and assessed food security as a possible effect modifier. We used data from the nationally representative WIC Infant and Toddler Feeding Practices Study-2. Our sample includes women-infant dyads interviewed through the first 13 months of age (n = 1672). We dichotomized WIC enrollment as occurring prenatally or after childbirth. The responsive feeding outcome was feeding on demand versus feeding on schedule. We used covariate-adjusted logistic regressions. Of women, 61.8% had a high school education or less and 62.9% lived at 75% or less of the federal poverty guideline. The majority (84.5%) of women enrolled in WIC before childbirth. In unadjusted estimates, 34% of women who enrolled prenatally practiced responsive feeding, compared to 25% of women who enrolled after childbirth. We found no evidence of food security as an effect modifier. In adjusted estimates, women who enrolled in WIC prenatally had 78% higher odds of practicing responsive feeding (OR: 1.78, 95% CI: 1.16, 2.73), compared to women who enrolled after childbirth. Prenatal enrollment in WIC was associated with higher odds of responsive feeding. Future studies should examine how the timing of WIC enrollment relates to responsive feeding in older children and over time. Full article
(This article belongs to the Special Issue Dietary Behaviors and Health Outcomes in Low-Income Populations)

Planned Papers

The below list represents only planned manuscripts. Some of these manuscripts have not been received by the Editorial Office yet. Papers submitted to MDPI journals are subject to peer-review.

Title: Use of the Infant Diet Quality Index Score (DQIS) for the identification of targets for nutritional intervention among infants of 4 to 6 months at risk of childhood obesity.
Authors: Campos M.; Palacios C,; Olave-Pinchón A.; Latimer S.; Santiago E.; Banna JC.
Affiliation: 1. Center of Community Outreach for Health Across the Lifespan, University of Puerto Rico, Medical Sciences Campus 2. Department of Dietetics and Nutrition, Florida International University 3. Puerto Rico Women and Children's Hospital 4. University of Puerto Rico Rio Piedras Campus 5. Title V University of Puerto Rico Medical Sciences Campus Program 6. Department of Human Nutrition, Food and Animal Sciences, University of Hawaii Manoa
Abstract: Objectives Healthcare providers have been called to intervene during the first 1000 days of life to reduce childhood obesity. Screening instruments that facilitate the identification of targets for intervention are not currently available. A Diet Quality Index Score (DQIS) was created and measured for its validity in predicting excessive weight gain in a sample of Latino infants. Evidence that infants with BMI percentiles ≥ 85 at 2 months developed early childhood obesity demands strategies to detect targets for intervention in a systems-based approach. Methods Secondary database analysis using data sourced from a lifestyle intervention project implemented among WIC participants. Assessments were completed on baseline while the infant was 0-2 months of age and follow up at 4-6 months. Socio-demographic and anthropometric characteristics of infants and their caregivers were evaluated. DQIS was calculated using an infant food frequency questionnaire. Descriptive analysis of the variables of interest was conducted. Correlation analysis between the numeric DQIS and categorical assessment of the scale was performed to determine the degree of association of values or risk category associated with a BMI z score percentile at or above 85 according to the age and gender appropriate WHO growth standards. Results 169 dyads were included in this study (Puerto Rico 54.4%), mean caregiver age was 27 y (4.94). 41.4% had achieved an educational level high school or less. In infants: 52% received care in health centers, 82.2% where up to date on vaccinations, 99.4% had an excellent DQIS score at baseline. At follow up 19.5% were found in good and 8.9% needs improvement to poor range. Mean BMI z scores increased from -0.52 (1.35) at birth to 0.9 (1.46) at follow up. Conclusions: The infant DQIS used between 4 to 6 months of life as a screening tool could assist non nutritional healthcare providers in the identification of intervention targets while a more detailed assessment is completed.

Title: In their own words: Parents and key informants share facilitators and barriers to healthy eating
Authors: Katherine E. McManus; Adrian Bertrand; Anastasia M. Snelling; Elizabeth W. Cotter
Affiliation: American University
Abstract: Background: Parents are integral in the development of eating behaviors that reduce children’s risk for high body mass index (BMI) and chronic disease. Objective: To understand the specific strategies that families use at mealtimes to promote their family’s health, along with the barriers they face in attending current nutrition education programming. Methods: Focus groups (in English and Spanish) were conducted with parents/caregivers (n = 22; 63.64% Black/African American, 13.64% Black but not African American, 18.18% Hispanic/Latinx) whose household was located in a community where 50% of residents’ gross income was <185% of the federal poverty level. Semi-structured interviews were conducted with 6 key informants with expertise in family health and nutrition. Inductive thematic analysis was used to identify themes across interviews.Results: Five general themes emerged from the interviews including perceptions of health, facilitators, barriers, relationships, desired changes, and program participation. Conclusion: Future community-based health promotion programs should include a broader definition of health to better address the individual and systemic barriers that perpetuate health inequities and make healthy eating difficult. Participants identified improving health literacy and cooking knowledge as areas of interest for future programming.

Title: Caregiver Perceptions of Environmental Facilitators and Barriers to Healthy Eating and Active Living During the Summer: Results from the Project SWEAT Sub-Study
Authors: Laura Hopkins; Amy Sharn; Heather Schier; Carolyn Gunther
Affiliation: Hopkins – Baldwin Wallace University, Department of Public Health and Prevention Sciences Others – The Ohio State University, Department of Human Sciences, Human Nutrition Program
Abstract: Objective: Project Summer Weight and Environmental Assessment Trial (SWEAT) was an observational, prospective study exploring child weight status and health trends during the summer months. The objective of this Project SWEAT sub-study was to examine caregiver perceptions of summertime neighborhood-level environmental barriers and facilitators to healthy eating and active living among elementary-age racial minority children. Methods: Caregivers with students in Pre-Kindergarten–5th grade were recruited from two schools located in low-income urban neighborhoods of Columbus, OH with a predominantly Black population. The sub-study occurred from June-August 2017. Participants completed a demographic survey. Participants engaged in an adapted HEALth MAPPS (Healthy Eating Active Living Mapping Attributes using Participatory Photographic Surveys) protocol, which included: 1) orientation; 2) photographing and geotagging facilitators and barriers to HEALth on daily routes using a Garmin Oregon 650 device; 3) in-depth interview (IDI) discussing images and routes taken; and 4) focus groups (FG). IDIs and FGs were transcribed verbatim. Analyses were guided by Grounded Theory and Interpretive Phenomenology and were coded by researchers (n=3) who engaged in comparative analysis, developed a codebook, and determined major themes. Results: Ten families enrolled and 9 completed the IDIs; 5 families participated in FGs. A majority (77.8%, n=7) of caregivers were African American, female (88.9%, n=8), and low-income (55.6%, n=5). IDI and FG themes include: 1) walkway infrastructure crucial for healthy eating and active living; 2) scarce accessibility to healthy, affordable foods; 3) multiple abandoned properties; and 4) unsafe activity near common neighborhood routes. Conclusions: Caregivers perceive multiple neighborhood-level barriers to healthy eating and activity during the summer months when school is closed. Findings from this study provide initial insights into environmental determinants of unhealthy summer weight gain in a sample of predominantly racial minority school-age children from low-income households.

Title: Cooking, Shopping, and Eating Behaviors Differ between African American and Hispanic Families: Implications for a Culturally-Tailored Meal Kit Intervention
Authors: Karla Shelnutt
Affiliation: University of Florida, Gainesville, United States
Abstract: Background: Families with low-income face barriers to preparing healthy meals, including decreased food access and limited time, and may turn to fast, low-quality, and inexpensive foods. Affordable and accessible meal kits may reduce these barriers. Objective: Explore the cooking, eating, and shopping behaviors of African American (AA) and Hispanic participants with low income and determine the knowledge of and preferences for a culturally appropriate meal kit intervention. Design: Focus groups were completed using a semi-structured questionnaire based on constructs of the Theory of Planned Behavior. Participants/setting: Trained researchers conducted focus groups with AA and Hispanic primary food preparers recruited from a church in an AA community with low income and a community resource center in a Hispanic community with low income, respectively. Focus groups were conducted in Spanish with the Hispanic community. Main outcomes: Participant cooking, eating, and shopping behaviors and knowledge of and preferences for a culturally appropriate meal kit intervention. Statistical analyses performed: Audio recordings were transcribed, and Spanish interviews were translated into English. Transcripts were coded individually and themes cross-checked by a second researcher until consensus was reached. Descriptive statistics characterized demographics. Results: AA participants (N=16) reported cooking on average two to three days per week and more often on weekends. Hispanic participants (N=15) reported cooking five days per week and more often during the week. Both groups identified cost as the number one consideration when shopping. Most were unfamiliar with meal kits but indicated they would try an affordable meal kit. Conclusion: AA and Hispanic participants differed in their cooking, eating, and shopping behaviors but were equally interested in trying meal kits if affordable and culturally appropriate.

Title: Comparison of emergency preparedness practices between food assistance program participants and non-participants in the United States.
Authors: Gina J. Fung; Michelle Lloyd Call; Laura K. Jefferies; Dennis L. Eggett; Rickelle Richards
Affiliation: 1. Department of Nutrition, Dietetics and Food Science, Brigham Young University, Provo, UT 84602, USA 2. Department of Statistics, Brigham Young University, Provo, UT 84602, USA
Abstract: Previous research has suggested households are meeting the Federal Emergency Management Agency’s 3-day emergency food and water storage recommendations. It is uncertain the impact of limited economic household resources on emergency preparedness practices. Thus, the purpose of this study was to compare emergency preparedness practices in households participating in United States’ food assistance programs with households not participating in these programs. A convenience sample of adults (n=572) completed an online Qualtrics survey. Descriptive statistics, chi-square statistics, and independent t-tests were used to measure differences in emergency preparedness practices between households participating in food assistance programs vs. non-participating households. Most households participating in food assistance programs felt prepared to provide household members with food and water during an emergency, which finding did not significantly differ from non-participating households. Households using food assistance programs had similar foods on-hand for an emergency compared to non-participating households. However, those using food assistance programs had significantly more baby formula/food and less vitamin/mineral supplements than non-participating households. Households participating in food assistance programs had less accessible cash to use in an emergency than non-participating households. Food assistance programs may be effective in providing enough food and water to help low-income families be prepared for an emergency.

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