The Relationship Between Food Insecurity, Weight Status, and Diet Quality Among Active Duty Service Members at a Large Military Installation

Purpose Food insecurity(FI) is an ever‐present concern in the United States (U.S.) that is generally associated with reduced diet quality (DQ) and unfavorable weight status (WS). The U.S. military consists of people from diverse socio‐economic backgrounds who may be affected by FI and its associated complications. However, little is known regarding the prevalence of FI amongst Active Duty Service Members (ADSM) or the impact of FI on military readiness. The primary objectives of this study were to determine the prevalence of FI and examine the relationship between FI, WS, and DQ among ADSM. A secondary objective was to examine environmental associations and behavioral characteristics that contribute to FI in ADSM. Materials/Methods A cross‐sectional study was conducted to examine FI, WS, and DQ of ADSM at Fort Bliss, TX. A convenience sample (n=197) of ADSM were recruited during in‐processing briefs for a six‐week period during June and July 2016. From the recruited sample, a total of 187 surveys were used in final data analysis. Select demographic data and behavioral characteristics were collected to examine associations with FI; they were indicated based on the possibility of their potential confounding effects and because of their known associations with FI. Level of FI was assessed using the validated U.S. Household Food Security Survey Module: Six‐Item Short Form. Individual WS and DQ were assessed using body mass index (BMI) categories and scores on the validated Rapid Eating Assessment for Patients (REAP) survey tool, respectively. Results Participants were 24.6 ± 5.6 (mean±standard deviation) years of age and mostly male (80.2%), unmarried (48.1%), junior‐enlisted in rank (E1–E4) (67.9%), with a high school degree as their highest educational attainment (41.2%). Forty‐one percent of ADSM surveyed were food insecure, exceeding the current national average (14%). There was no relationship between FI, WS, and DQ (F [3,164] = 1.039, p =0.377, r 2 =0.006). Significant associations were seen between FI and living in military barracks (p=0.045), military pay grade (p=0.001), level of education (p=0.010), and averaging <5hrs of sleep per night (p=0.007). Individual FI was positively associated with aspects of food resource management, including preparing fewer meals at home during the week (p=0.042), difficulty purchasing(p=0.036) and preparing (p=0.000) food, and interest in classes on food purchasing and preparation on a budget (p=0.004). Conclusions Active Duty Service Members in our study were three times more food insecure than the U.S. civilian population. Despite the high prevalence of FI, no associations were seen between FI, WS, and DQ. Components of military service, such as mandatory physical fitness testing, weight standards, and dietary restrictions during basic training may assuage the impact of FI on WS and DQ in this population. However, food resource management was a significant barrier to food security in ADSM. Future research examining FI, WS, DQ and food resource management in other military populations, as well as qualitative inquiry, is warranted. Support or Funding Information Retired Army Medical Specialist Corps Association (RAMSCA) grant