ASPO Abstracts
The association between food-away-from-home frequency, low diet quality, and food insecurity among U.S. adult cancer survivors
Category: Survivorship & Health Outcomes/Comparative Effectiveness Research
Conference Year: 2023
Abstract Body:
Purpose The purpose of this study is to evaluate patterns of adult cancer survivors' food-away-from-home (FAFH) purchases by food security status and other demographic factors, and examine the association between FAFH frequency (number of meals/week) and diet quality in adult cancer survivors of varying levels of food security (FS). Methods This study included 3,368 participants with a history of cancer and aged ≥20 years from the 2007-2018 cohorts of the National Health and Nutrition Examination Survey (NHANES). Data from the NHANES Consumer Behavior Survey, U.S. Food Security Survey Module (U.S.-FSSM), and two 24-hour recalls were used to assess FAFH expenditures, FS status, and diet quality (Healthy Eating Index (HEI) 2015 total scores). Weighted means and 95% CIs were calculated to describe demographic characteristics by level of FS. Multiple linear regressions and Poisson regressions were used to predict associations between FAFH purchasing variables and demographic characteristics. Multinomial logistic regressions were used to determine the odds of having a lower total HEI score by quantile of FAFH frequency. Results Most cancer survivors were food secure, non-Hispanic White males and females, >150% poverty-income ratio, and had at least a high school diploma or GED. Compared to food secure cancer survivors, food insecure survivors, on average, had a lower HEI 2015 total score, fewer FAFH expenditures, and spent a lower percentage of their monthly food budget on FAFH. Being food insecure was inversely and significantly associated with monthly expenditures on FAFH meals and percentage of monthly food budget spent on FAFH. Food insecure survivors with FAFH frequency of 1-2 times/week had greater odds of having a higher HEI 2015 total score, while those with FAFH frequency of 3-4 times/week had greater odds of having a lower HEI 2015 total score. Conclusions Results from this study can help inform future interventions and policy change within the oncology setting to improve nutritional access needs of cancer survivors. More research is needed to understand how food insecurity impacts cancer survivor's food choices and how they prioritize their household and medical expenses in relation to food and nutrition.
Keywords: cancer, food insecurity, diet quality