Nourish Futures Network

Determinants of Health

We are a collaborative research group leading knowledge exchange and generation on issues of food security during preconception, pregnancy, and early life.

The aim of the network is to share knowledge and expertise, create a platform for collaboration, bring together research and evidence, policy and practice, voluntary sector, and those with lived experience on issues of food insecurity and the crucial period of preconception, pregnancy, and early life. By working together, we aim to generate change, to improve life course heath for women and their families.

 

Challenge

The aim of the network is to share knowledge and expertise, create a platform for collaboration, bring together research and evidence, policy and practice, voluntary sector, and those with lived experience on issues of food insecurity and the crucial period of preconception, pregnancy, and early life

Solution

Our current areas of interested are in exploring the different and important components of maternal and child food insecurity during this vital life course stage including a clinical and mechanistic perspective on the maternal and child life course health impacts of food insecurity; a societal and public health perspective on intersectional inequalities driving food insecurity; a policy and practice perspective on interdisciplinary and multi-sector strategies to mitigate and respond to food insecurity. By working together, we aim to generate change, to improve life course heath for women and their families.

Impact

Our current areas of interested are in exploring the different and important components of maternal and child food insecurity during this vital life course stage including a clinical and mechanistic perspective on the maternal; and child life course health impacts of food insecurity; societal and public health perspective on intersectional inequalities driving food insecurity; and policy and practice perspective on interdisciplinary; and multi-sector strategies to mitigate and respond to food insecurity.

Partners

Links

Morales ME, Berkowitz SA. The relationship between food insecurity, dietary patterns, and obesity. Current nutrition reports. 2016;5(1):54–60.

Seligman, H.K.; Laraia, B.A.; Kushel, M.B. Food insecurity is associated with chronic disease among low-income NHANES participants. J. Nutr. 2010, 140, 304–310. [CrossRef]

Kirkpatrick, S.I.; Tarasuk, V. Food Insecurity Is Associated with Nutrient Inadequacies among Canadian Adults and Adolescents. J. Nutr. 2008, 138, 604–612. [CrossRef] [PubMed]

Martin, M.A.; Lippert, A.M. Feeding her children, but risking her health: The intersection of gender, household food insecurity and obesity. Soc. Sci. Med. 2012, 74, 1754–1764. [CrossRef]

Whitaker, R.C.; Phillips, S.M.; Orzol, S.M. Food insecurity and the risks of depression and anxiety in mothers and behavior problems in their preschool-aged children. Pediatrics 2006, 118, e859–e868. [CrossRef]

Rose-Jacobs, R.; Black, M.M.; Casey, P.H.; Cook, J.T.; Cutts, D.B.; Chilton, M.; Heeren, T.; Levenson, S.M.; Meyers, A.F.; Frank, D.A. Household food insecurity: Associations with at-risk infant and toddler development. Pediatrics 2008, 121, 65–72. [CrossRef]

Food and Agricultural Organisation (FAO). The State of Food Security and Nutrition in the World. Accessed Feb 9, 2024.

Zinga, J; van der Pligt P, McKay F. Views and preferences of food-insecure pregnant women regarding food insecurity screening and support within routine antenatal care. Health Expectations. 2024. 27: e13956.

Li L, Ji J, Li Y, Huang YJ, Moon JY, Kim RS. Gestational diabetes, subsequent type 2 diabetes, and food security status: National Health and Nutrition Examination Survey, 2007-2018. Prev Chronic Dis 2022;19:E42.

Laraia BA, Siega-Riz AM, Gundersen C, Dole N. Psychosocial factors and socioeconomic indicators are associated with household food insecurity among pregnant women. J Nutr. 2006;136(1):177–82.

Arzhang P, Ramezan M, Borazjani M, et al. The association between food insecurity and gestational weight gain: a systematic review and meta‐analysis. Appetite. 2022;176:106124.

Carmichael SL, Yang W, Herring A, Abrams B, Shaw GM. Maternal food insecurity is associated with increased risk of certain birth defects. J Nutr. 2007;137(9):2087–92.

Augusto ALP, de Abreu Rodrigues AV, Domingos TB, Salles‐Costa R. Household food insecurity associated with gestacional and neonatal outcomes: a systematic review. BMC Pregnancy Childbirth. 2020;20(1):229.

Food insecurity, the restricted availability and accessibility of safe and nutritious food, both with and without hunger is a critical public health issue. An estimated 2 billion people globally are considered to be food insecure (1). Food insecurity has significant health implications for both adults and children including increased risk of chronic disease (2), severe nutritional deficiencies (3) weight loss or weight gain (4), adverse effects on a range of mental health conditions (5) and delayed growth and development in children (6).

Women are more likely than men to disproportionately bear the burden of food insecurity (7,8). Pregnant and postnatal women are particularly vulnerable to food insecurity and its negative impacts due to increased nutritional needs of the growing baby during pregnancy and for adequate breastfeeding. Food insecurity in pregnancy has been shown to be associated with multiple adverse health outcomes for the mother and baby. These include pregnancy complications such as gestational diabetes mellitus (9), depression and anxiety (10), and both inadequate and excess gestational weight gain (11). Babies born to mothers who are food insecure are at higher risk for low birth weight, congenital abnormalities (12) and preterm birth (13,14). The health burden on mothers and children resulting from food insecurity is significant and must urgently be addressed.

Addressing the crucial issue of food insecurity in pregnancy and the first 1000 days is a major public health challenge. Currently there are a lack of antenatal screening and management guidelines and a lack of effective and sustainable solutions which target this issue. In the interest of supporting best maternal and child health outcomes, guided, multidisciplinary interventions and translational public health research (15) is urgently needed. Collectively, we must prioritise action towards developing effective strategies which relieve the burden of food insecurity in pregnancy and the first 1000 days.

Projects

Title: Food insecurity and health in the first 1,001 days.

Aim: To explore the experiences of food insecurity during and after pregnancy amongst women in Lambeth, South London (UK).

Funders: Economic and Social Research Council funded 12-month postdoctoral fellowship.

Dates: 1/10/2023 to 30/09/2024

Investigators: Academic: Dr Zoë Bell, Professor Seeromanie Harding, Dr Angela Flynn, Collaborator: Lambeth Health Determinants Research Centre (HEART).

Title: Food, Pregnancy and Me: Exploring food insecurity in pregnancy in the UK to inform future Public Health intervention needs

Aim: To identify the levels of food insecurity in pregnancy in the North East and West Midlands (UK), how this impacts on diet and pregnancy health outcomes for pregnant people and their babies, the costs of this to maternity services and wider healthcare, and to explore experiences and support needs.

Funders: National Institute for Health Research (NIHR) School for Public Health Research (SPHR)

Dates: 01/09/2023 to 31/07/2025

Investigators: Academic Leads: Nicola Heslehurst (Newcastle University, UK), Kiya Hurley (University of Birmingham, UK), Kate Jolly (University of Birmingham, UK), Heather Brown (Lancaster University, UK); Academic Co-investigators: Zainab Akhter, Ella Dyer, Judith Rankin, Steph Scott, Gina Nguyen, Kerry Brennan-Tovey (Newcastle University), Amelia Lake (Teesside University), Rachel Loopsta (University of Liverpool). Collaborators Public Health: Alice Wiseman, Emma Gibson (Gateshead Council); Angela Baker, Harbir Nagra (Coventry City Council); Sushma Acquilla (Independent); Maternity Services: Christine Moller-Christensen (Gateshead NHS Trust); Nicola Flint (Coventry NHS Trust); Voluntary Sector: Dianne Williams (Moat House Community Trust, Coventry Feeding Network); Sonya Dickie (Felling Food Network).

Project website/other project links (e.g. trial registration, PROSPERO protocol etc?): in development

Title: Exploring and responding to food insecurity in preschool children in Somerset 

Aim: To delve into both the impacts and what can be done to prevent and alleviate food insecurity within the rural landscape using systematic review and intervention design methods.

Funders: UoB PGR Scholarship: NIHR School for Public Health Research (SPHR) /Somerset County Council

Dates: April 2023- April 2027

Investigators: Cat Holt (student); Prof Ruth Kipping (Bristol University), Dr Alice Porter (Bristol University), Dr Nicola Heslehurst (Newcastle University) (supervisors)

Project links: Prospero protocol  https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=453155

Project Titles:

  • Supporting Pregnancy fOOd and Nutrition Security (SPOONS) in Denmark’s most marginalized neighbourhoods (Short title=SPOONS in Denmark)
  • Supporting Pregnancy fOOd and Nutrition Security (SPOONS): A comparative social epidemiology of pregnancy food insecurity across community samples from three middle- and high- income countries with diverse policy conditions (Canada, Denmark, Mexico) (Short title=SPOONS International)

Aims: To explore relationships between health indicators, socio-political conditions, diet quality, and food security status among parents-to-be and parents of infants and toddlers; to identify and develop bottom-up, community-based strategies for mitigating household food insecurity for families experiencing vulnerability during the first 1000 days post-conception

Funders: The European Union’s Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie grant agreement No 754513; The Aarhus University Research Foundation

Dates:

SPOONS in Denmark’s most marginalized neighbourhoods: Aug 2021-Jan 2024;

SPOONS International: March 2024-Aug 2025

Investigators: PI: Luseadra McKerracher (student co-investigators, SPOONS in Denmark: Gali Ibrahim, Hamda Waberi, Hamdi Egal, James Gibb; student assistants, SPOONS in Denmark: Julia Labriciossa, Katherine Taplin, Christopher Jensen); co-PIs on SPOONS International: Hiliary Monteith, Tracey Galloway, Deborah M Sloboda, Alejandra Nuñez de la Mora

Project website/other project links (e.g. trial registration, PROSPERO protocol etc?):

https://spoonsskeer.wixsite.com/my-site

https://osf.io/y3mb2/

Leadership team

Dr Nicola Heslehurst, Senior Lecturer in Maternal Nutrition, Newcastle University, UK

Nicola leads on an NIHR School for Public Health Research (SPHR) research programme exploring prevalence, impact and intervention needs for pregnant people experiencing food insecurity. She has supervised multiple student projects relating to food insecurity in this life course period including associations with maternal weight, diet, pregnancy outcomes, and breastfeeding; women’s and children’s experiences of food insecurity; and news media framing of food insecurity among mothers in the first 1,000 days.

Email: Nicola.heslehurst@ncl.ac.uk

Profile: https://www.ncl.ac.uk/medical-sciences/people/profile/nicolaheslehurst.html

ORCID: 0000-0001-8656-2319

X:  @NHeslehurst

A/Prof Fiona McKay, Associate Professor of Health Equity, Deakin University, Australia

Fiona is an Associate Professor of Health Equity in the School of Health and Social Development and the Institute for Health Transformation. Her research interests relate to the study of reliance and how different groups survive and thrive in situations of adversity. Her work includes those experiencing forced displacement, issues of refuge and asylum, those experiencing food insecurity, single mothers experiencing financial insecurity, and drug users who struggle to access health services, in the Australian setting and internationally. Much of her current work is related to the experiences of food insecurity amongst a diverse range of populations, where she seeks to understand the phenomenon better and explore new ways to describe it. She has a considerable body of work exploring ways to measure and respond to community hunger, strong relationships with the emergency and community food sector, and is skilled in various methods used to explore of hunger and service provision across the sector, including qualitative approaches, policy analysis, and co-design. She leads a group of qualitative researchers exploring food security, with research based in Australia, the UK, and India.

Email : Fiona.mckay@deakin.edu.au

Profile: https://www.deakin.edu.au/about-deakin/people/fiona-mckay

ORCID: 0000-0002-0498-3572

X: @feemck

 Dr Paige van der Pligt, Senior Lecturer in Nutrition and Dietetics, Mid-Career Researcher Institute of Physical Activity and Nutrition, Deakin University. Advanced Accredited Practising Dietitian.

Paige is an Advanced Accredited Practicing Dietitian with over fifteen years’ experience working across the public and private healthcare sectors. She is Senior Lecturer in Nutrition and Dietetics, and co-leads Deakin University’s Institute for Physical Activity and Nutrition Health in the First 2000 Days research group. Paige’s research targets the link between pregnancy nutrition, food insecurity and diet quality with maternal and neonatal health and disease. Her work explores how adequate access to effective antenatal and postnatal nutrition and healthcare systems for all women can be achieved. She has previously and is currently supervising multiple research and PhD students, is an experienced qualitative and quantitative researcher and has previously designed and implemented pilot interventions with postnatal women.

Email: p.vanderpligt@deakin.edu.au

Profile: https://www.deakin.edu.au/about-deakin/people/paige-van-der-pligt

ORCID: https://orcid.org/0000-0003-4391-9431

X: @paigevdp

 Dr Zoë Bell, Research Associate, King’s College London, UK

Zoë is an ESRC-funded postdoctoral fellow exploring food insecurity in the first 1001 days. Her research adopts multiple methods, with a particular focus on qualitative and co-development approaches. Zoë’s fellowship project is exploring the experiences of food insecurity both during and after pregnancy to inform future support recommendations. This work builds from her doctoral research which was amongst women and children broadly. Her work is informed by her research background within the fields of biomedical science, human nutrition, and social science research methods training.

Zoë has co-supervised a variety of student projects covering women’s health, including a variety of food insecurity specific projects. She is also currently serving as a co-opted events operations committee member for The Association for the Study of Obesity (ASO).

Email: Zoe.bell@kcl.ac.uk

Profile: https://www.kcl.ac.uk/people/zoe-bell

ORCID: https://orcid.org/0000-0003-2416-4184

X: @ZoBell20

 Dr Luseadra McKerracher, Assistant Professor, Department of Public Health, Aarhus University, Denmark

Luseadra McKerracher leads two research projects aimed at investigating relationships between health and wellbeing during pregnancy and peri-partum, food security, and the broader socio-political environment, one of which focuses on Denmark and its so-called “ghetto plan” and one of which takes a cross-national comparative perspective. She also previously co-led a project in Canada on pregnancy nutrition called the Mothers to Babies Project, in which food security emerged as a dominant theme. In connection with these three projects, Luseadra has co-supervised 3 master’s theses and 9 undergraduate research projects and internships.

Luseadra is generally interested in understanding socio-environmental factors that shape pregnancy and peri-partum nutrition and health and in developing innovative and community-oriented strategies for health promotion during the pregnancy and peri-partum periods. In addition to the pregnancy food security projects detailed on this site, she is a co-investigator on a number of other projects on health equity and health promotion using a lifecourse perspective, most notably The Art of Creation Study and The unchARTed Project.

Email: luseadramckerracher@ph.au.dk

Profile: https://www.au.dk/en/show/person/luseadramckerracher@ph.au.dk

 Dr Kiya Hurley, Research Fellow, School of Geography, Earth, and Environmental Sciences, University of Birmingham, UK

Kiya is an early career researcher and programme coordinator for the NIHR School for Public Health Research (SPHR) Children, Young People & Families research programme. Kiya is a Public Health Nutritionist and co-leads the Food, Pregnancy & Me study, exploring food insecurity in during preconception and pregnancy. She is also leading a project exploring food related needs of young people and families in emergency and temporary accommodation and the role of housing providers in prevention of food insecurity. Kiya is currently supervising one masters student exploring food insecurity in secondary school children and one PhD student exploring the roles of schools in formal and informal food aid for families and the cultural differences in food aid provision, access, and utilisation in Birmingham.

Email: k.hurley@bham.ac.uk

Profile: Dr Kiya Hurley – School of Geography, Earth and Environmental Sciences – University of Birmingham

ORCID: https://orcid.org/0000-0002-5084-5410

X: @kelleherhurley

 Julia Zinga, Dietitian and PhD Candidate. Royal Women’s Hospital, and School of Health and Social Development, Deakin University, Australia

Julia’s research interests relate to food insecurity during pregnancy, and how the antenatal healthcare system could respond to this public health issue through effective screening and provision of support strategies. Julia has explored the experiences of food-insecure pregnant women, and their views regarding food insecurity screening within routine antenatal healthcare. Julia also works as a clinical dietitian to provide nutrition support to pregnant women at one of Australia’s largest maternity hospitals, which services communities experiencing socioeconomic disadvantage.

Email: julia.zinga@deakin.edu.au

Profile: Julia Zinga | Deakin

ORCID: Julia (0000-0003-3339-9102) – ORCID