To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Myopia is a critical public health issue, particularly among adolescents. This study investigates the association between adherence to a Mediterranean-style diet and the odds of myopia in US adolescents. A cross-sectional analysis was conducted using National Health and Nutrition Examination Survey (NHANES) data from 2005 to 2008, involving 2473 participants aged 12–18 years. Adherence to the diet was assessed using the alternate Mediterranean diet (aMED) score. Myopia was defined as a spherical equivalent of ≤–0·50 dioptres (D). Multivariable logistic regression models adjusted for age, sex, race, education level, BMI, poverty income ratio and total energy intake were used to examine the association between aMED and myopia. Additionally, restricted cubic spline regression was used to explore non-linear relationships, and mediation analysis was conducted to identify potential biological pathways. Of the participants (median age: 15 years; 50·5 % male), 41 % were identified as having myopia. Participants with myopia had significantly lower aMED scores compared with non-myopic individuals (P < 0·05). Higher adherence to the aMED was associated with lower odds of myopia (OR: 0·830, 95 % CI 0·712, 0·968). A significant dose–response relationship was observed, with adolescents in the highest aMED quintile having a 41 % lower odds of myopia compared with the lowest quintile (OR: 0·592, 95 % CI 0·368, 0·952). The association was partially mediated by dietary cholesterol and eicosatetraenoic acid. In conclusion, adherence to a Mediterranean-style diet in adolescents is associated with a lower odds of myopia. Addressing diet quality may mitigate health risks related to myopia development.
Refugees are susceptible to food insecurity. In high-income countries (HIC), settlement workers (SW) provide information, including food security information resources, to newly arrived refugees. Australia has a range of resources, but their use in settlement work is unknown. This study’s aims were to explore SW’s resource use with refugee clients.
Design:
This descriptive, qualitative study explored SW’s perceptions regarding resource use. One-on-one interviews, using a semi-structured guide, were conducted. The Technology Acceptance Model’s usage constructs (including Actual Use and Perceived Usefulness) informed the guide and analytical constructs. Under these constructs, emergent usage themes were identified.
Setting:
Six Australian cities.
Participants:
Settlement workers.
Results:
Fourteen workers were interviewed. Thirteen worked for government-related departments. Most used resources as part of client welcome packs to address acute food insecurity and/or support clinical deficiency issues. Print, pictorial, translated and co-designed resources were perceived to be most useful. Less useful were resources with limited cultural tailoring, translation issues and high literacy demand. There was limited use of digital resources due to variations in clients’ digital access and literacy. Opportunities for improvement include streamlining access, addressing topics such as clinical deficiencies related to food insecurity and increasing culturally nuanced translation.
Conclusions:
Development of culturally appropriate resources, facilitating resource access and improved food culture information may help SW better support refugee populations with food security challenges during resettlement in HIC.
Telomere length is a biomarker of ageing, with shorter lengths associated with a higher risk of age-related diseases and mortality. Oxidative stress and inflammation predominantly contribute to telomere shortening. Diets rich in antioxidant and anti-inflammatory properties may help preserve telomere length. Nuts and seeds contain antioxidant and anti-inflammatory nutrients and bioactive compounds. Their consumption is recognised as protective against age-related conditions. The objective of this review is to evaluate the role of nut and seed intake on telomere length in humans. A systematic search was conducted in four databases from inception to 12 March 2024 to identify observational and interventional studies assessing nut and seed intake and measuring telomere length as an outcome in adults (aged ≥ 18 years). Data from the included articles were extracted by one reviewer and verified by another reviewer. Out of the nine observational studies included, three reported positive associations between nut and seed intake and telomere length. None of the four interventional studies included reported a significant positive effect. Meta-analysis was not performed due to high variability in reporting telomere length measurements. The evidence is insufficient to confirm a beneficial role of nut and seed intake on telomere length. Adequately powered long-term intervention studies are needed.
Muscular dystrophy (MD) encompasses inherited myopathies characterised by progressive skeletal and cardiac muscle degeneration, chronic inflammation and metabolic dysfunction. While emerging therapies show pre-clinical promise, few reach clinical translation, highlighting the need for supportive interventions to improve function and quality of life (QoL). Nutritional strategies may offer such benefits; however, limited data exist characterising diet in MD or associations with functional outcomes. This study assessed diet, nutritional status and associations with muscle strength, function and QoL in MD adults. Adults with MD (n 39; FSHD = 8, LGMD = 9 and Other = 22) and matched Controls (n 17) completed two 3-d food records, strength/function assessments and QoL questionnaires. Between-group differences were analysed using t tests or Mann–Whitney U and associations using Pearson’s r or Spearman’s Rho (P < 0·05). Compared with controls, individuals with MD consumed more energy (89 % v. 35 % exceeded RDI, P = 0·023), but less carbohydrate (–21 %, P = 0·013), sugar (–31 %, P = 0·004), protein (–15 %), BCAA (–31 %, P = 0·049) and vitamin C (–43 %, P = 0·009). MD participants demonstrated reduced muscle thickness, strength, function and reported lower QoL and physical capacity (all P < 0·05). Protein intake positively correlated with strength and function (P < 0·05); branched-chain amino acids intake was associated with lean mass (r = 0·442, P = 0·02) and strength (r = 0·372, P = 0·036). Findings indicate adults with MD consume excess energy but insufficient protein and micronutrients, supporting the need for adult MD-specific dietary guidance to optimise musculoskeletal health and QoL.
This prospective study investigated the associations of various diet quality indices with mortality in Japan. Participants were 13 355 men and 15 724 women from the Takayama study. Eight diet quality indices were assessed using an FFQ: the Dietary Approaches to Stop Hypertension, alternative Mediterranean diet scores, Healthy Eating Index-2015, Alternate Healthy Eating Index-2010, Nutrient Rich Food Index 9.3, Diet Quality Score for Japanese, Japanese Food Guide Spinning Top and twelve-item Japanese Diet Index. Cox proportional models estimated hazard ratios and 95 % CI for all-cause and cause-specific mortality in a 1 sd difference for each index, with adjustment for confounders. During a mean follow-up of 14·1 years, 5339 deaths were recorded. Hazard ratios (95 % CI) per 1 sd higher index were 0·90 (0·87, 0·93) for Alternate Healthy Eating Index-2010, 0·92 (0·89, 0·95) for Diet Quality Score for Japanese, 0·93 (0·91, 0·96) for Nutrient Rich Food Index 9.3, 0·94 (0·92, 0·97) for alternative Mediterranean diet and Dietary Approaches to Stop Hypertension, 0·94 (0·91, 0·97) for Japanese Food Guide Spinning Top, 0·94 (0·91, 0·98) for twelve-item Japanese Diet Index and 0·97 (0·94, 0·996) for Healthy Eating Index-2015. Similar protective associations were observed for CVD mortality, but not for cancer mortality. These findings suggest that all eight indices are associated with lower mortality and that the strength of associations varies across indices; the Alternate Healthy Eating Index-2010 showed relatively strong associations, followed by the Diet Quality Score for Japanese, whereas the associations of the Healthy Eating Index-2015 appeared relatively weaker in this Japanese population.
There is limited research on the association between soda consumption and the risk of metabolic syndrome (MetS), particularly during the COVID-19 pandemic. This study investigated the relationship between soda consumption and MetS in Korean adults, stratified by sex, and compared differences before and after the pandemic using data from the Korea National Health and Nutrition Examination Survey (2017–2021). A total of 13 051 adults aged 19–64 years were included. Soda consumption was assessed using 24-h recall and categorised into five groups (non-drinkers and four quartiles). Multivariable logistic regression models were used to estimate OR and 95 % CI for MetS and its components. After adjusting for multiple covariates, no significant association was found between soda consumption and MetS overall. However, adults in the highest quartile of soda consumption (≥ 373 g/d) had higher risks of abdominal obesity (P-trend = 0·006) and hypertriglyceridaemia (P-trend = 0·003), compared with non-drinkers. When analysed by gender, women in the highest quartile of soda consumption (≥ 315 g/d) had significantly higher risk of MetS (OR = 1·70; 95 % CI: 1·08, 2·68), and multiple MetS components, whereas no significant associations were obserbed in men. Post-pandemic analysis revealed a significant association between high soda consumption (≥ 416 g/d) and MetS (OR = 1·56; 95 % CI: 1·04, 2·34), which was NS in the pre-pandemic period (P–interaction = 0·031). These findings suggest that high soda consumption may increase the risk of MetS, particularly among Korean women.
Coenzyme Q10 (CoQ10) is biologically plausible as an ergogenic aid through roles in mitochondrial energy production and antioxidant defence, yet findings from randomised trials are inconsistent. This review included twenty-four studies from six databases published up to November 2025, assessing effects of CoQ10 on exercise performance, subjective fatigue and circulating CoQ10 levels in healthy adults. Randomised trials comparing CoQ10 with placebo were synthesised using a three-level model. Risk of bias was assessed with RoB2 and certainty judged with Grading of Recommendations Assessment, Development, and Evaluation. Supplementation consistently increased blood CoQ10, indicating robust biochemical responsiveness. In contrast, performance effects were small and inconsistent. In primary analyses, chronic supplementation showed a small benefit, whereas acute supplementation showed no benefit. After excluding outliers, the chronic effect was no longer stable and the acute effect remained trivial. All subgroup analyses were restricted to chronic supplementation. Within this context, aerobic endurance was significant in primary analyses but became borderline after outlier exclusion, while anaerobic and strength outcomes showed little change. Evidence for reduced subjective fatigue was suggestive and became more consistent after outlier exclusion. Benefits in trained individuals were unstable and became consistent only after outlier exclusion. No stable dose–response pattern emerged for supplementation dosage or duration. Heterogeneity and moderate-to-high risk of bias reduced certainty. Collectively, CoQ10 reliably elevates circulating levels but provides at most modest and context-dependent benefits for exercise performance, largely under chronic use. Overall, certainty is very low to low. Well-controlled randomised trials that standardise formulation, dose and duration and examine sex-specific and endurance-related responses are needed.
Food literacy and mindful eating are increasingly recognised as key factors in the prevention and management of chronic diseases, particularly type 2 diabetes mellitus (T2DM) and metabolic syndrome (MetS). This study aimed to assess the association between food literacy and mindful eating and the risk of developing T2DM and MetS. This cross-sectional study included 1091 adults (777 females, 314 males) aged 18–65 years. General characteristics, anthropometric measurements, risk of T2DM (Finnish Diabetes Risk Score (FINDRISC)) and MetS (Metabolic Syndrome Index), food literacy (Food Literacy Tool) and mindful eating (Mindful Eating Inventory) were assessed using a questionnaire. Food literacy and mindful eating scores were significantly and negatively correlated with both the FINDRISC score (r = −0·153 and r = −0·168, respectively; P < 0·001) and the Metabolic Syndrome Index score (r = −0·181 and r = −0·171, respectively; P < 0·001). Linear regression analyses indicated that age, marital status, education level, BMI, waist circumference and total scores from the Food Literacy Tool and the Mindful Eating Inventory were significant predictors of the risk of T2DM (R2 = 0·580; P < 0·001) and MetS (R2 = 0·440; P < 0·001). Given the association between food literacy, mindful eating and the risk of T2DM and MetS, public health interventions should incorporate these factors. The long-term effects of such interventions should be evaluated, and their adaptability to different sociocultural contexts should be explored to support effective global prevention and management.
White potatoes are a major contributor to energy and nutrient intake in the US, which supports investigating their relationship with cardiometabolic health. This cross-sectional analysis assessed relationships of total white potato intake and dietary patterns containing white potatoes prepared by various methods with diet quality and markers of cardiometabolic health in adults categorized by diabetes status. The dietary intake assessment component of NHANES (2001-2018), What We Eat in America (WWEIA), was linked with the Food and Nutrient Database for Dietary Studies and Food Patterns Equivalents Database to rank consumption of white potato-containing foods. Dietary patterns were determined by percent calories from white potatoes and main food groups in WWEIA using cluster analysis. Regression analysis assessed trends in individuals with (n=5,467) and without (n=38,159) diagnosed diabetes. P < 0.01 was significant. The most consumed white potato-containing foods were French fries, potato chips, and home fries. In adults without diagnosed diabetes, total white potato intake was positively associated with glucose, insulin, HOMA-IR, and waist circumference. Glycated hemoglobin was lower in those who primarily consumed dietary patterns with baked/boiled potatoes and waist circumference was higher in those who primarily consumed dietary patterns with chips, fried potatoes, or mashed potatoes compared to adults with no white potato intake. In adults without diagnosed diabetes, total white potato intake was associated with greater cardiometabolic risk, which may be due, in part, to frying as the predominate preparation method of white potatoes in the US.
This study aimed to identify linear growth trajectories from 0 to 5 years and assess their associations with cognitive function and school achievement in Ethiopian children aged 10 years. Latent class trajectory modelling was used to identify distinct height-for-age (HAZ) trajectories. Cognitive function was assessed using the Peabody Picture Vocabulary Test, while school achievement was measured by math, English and science (MES) combined scores and grade-for-age. Associations were assessed using multiple linear or logistic regressions. We identified four distinct HAZ trajectories. Decreasing trajectory (n 145, 31·9 %) started high at birth but dropped sharply. The increasing-decreasing trajectory (n 196, 43·2 %) increased up to 3 months, followed by a decrease. The stable low (n 74, 16·3 %) had low HAZ at birth, followed by a slight decrease. The rising trajectory (n 39, 8·6 %) started low but then increased to HAZ above, yet close to zero. At 10 years, children in the rising trajectory had 4·54 (95 % CI: −0·45, 9·55, P = 0·075) higher MES combined score and 2·4 times (95 % CI: 1·12, 5·15, P = 0·025) higher odds of being in the appropriate grade-for-age compared to those in the increasing-decreasing trajectory. The association between stable low and decreasing trajectory with appropriate grade-for-age had odds ratio close to null. In conclusion, we found that three of the four linear growth trajectory classes showed a declining pattern. Data suggest that greater linear growth in early childhood may be associated with higher school achievement and better cognitive function.
Undernutrition is common amongst older people and can lead to adverse health outcomes and increased dependence. This review focuses on an aspect of undernutrition that is often overlooked, namely loss of appetite, and will discuss the challenges in this under-researched field from the perspective of geriatric medicine. Appetite decline is common in later life and predicts undernutrition in older populations. As such, timely identification and intervention on poor appetite could delay onset or progression of undernutrition to optimise healthy ageing and maintain independence. In addition, management of undernutrition ultimately requires the individual to meet their nutritional requirements. However, unless attention is paid to mitigating appetite decline, strategies to improve intake are likely to be ineffective. Treatment for appetite decline is challenging due to the multiple and complex underlying mechanisms. Current evidence is limited to a few trials targeting older people including flavour enhancement and fortification or supplementation, lifestyle measures such as increasing physical activity and social interaction, and medications, all with mixed results. Progress on treatments for appetite decline has been hampered by a lack of distinction from undernutrition but also perhaps the approach to it as a concept. Categorising appetite decline in ageing as a geriatric syndrome could aid progress in the unification of approaches to mechanistic research, assessment and management strategies, which are likely to be most effective when in multi-component form and underpinned by the principles of Comprehensive Geriatric Assessment (CGA).
Sustainable diets can improve environmental health by supporting food security and promoting healthy living for future generations. This study aimed to assess changes over time in the consumption of foods within the national diet and diet-related environmental indicators, specifically greenhouse gas emissions (GHGE) and water footprint (WF). Individual food consumption was assessed using 24-hour dietary recalls from the Türkiye Nutrition and Health Surveys (TNHS) conducted in 2010 and 2017. GHGE and WF were calculated based on these dietary data. According to the TNHS 2010 and 2017, GHGE increased by 16·1 %, total WF by 17 %, green WF by 19·3 %, blue WF by 9·4 % and grey WF by 10·9 % (p < 0·001). During the same period, the consumption of red meats (by 72 %), eggs (by 42·5 %) and fats (by 53·6 %) increased significantly (p < 0·001). Conversely, the most notable decrease in consumption was observed for fresh vegetables and fruits, which declined by 17·5 % and 6·9 %, respectively (p < 0·001). In 2010 and 2017, red meats (GHGE: +29·8 %; total WF: +23·6 %) and fats (GHGE: +14·3 %; total WF: +13·6 %) were the foods that increased their contribution to GHGE and total WF the most. Although the GHGE and total WF values of Türkiye’s national diet remain below the global average, both indicators increased in 2017 compared to 2010. Despite the rising consumption of animal-based foods in recent years, the predominance of cereals in the national diet has played a key role in keeping GHGE and total WF below the global average.
The Global Leadership Initiative on Malnutrition (GLIM) provides a consensus-based diagnostic framework for malnutrition in hospitalised patients, which includes at least one phenotypic and one aetiologic criterion. In GLIM, appendicular skeletal muscle based on bioelectrical impedance analysis (ASMBIA) and calf circumference (CC) are two common techniques for muscle mass assessment, but their accuracy remains debated. Therefore, the present study evaluates the prevalence of malnutrition upon hospital admission applied by GLIM criteria and mainly compares the effectiveness of ASMBIA and CC. We screened a total of 605 patients from four hospitals in Indonesia (August–October 2024). Multivariate logistic regression analysed associations with clinical outcomes. Prevalence of malnutrition was 72·7 % using three phenotypes, 55·9 % with two phenotypes, 22·1 % via ASMBIA and 62·6 % using CC. Significant associations (P < 0·05) were found between malnutrition and weight loss, BMI, mid-upper arm circumference, handgrip strength, sarcopenia and fat-free mass index. For all criteria combinations, sensitivity was greater in CC (86·1 %), followed by two phenotypes (76·8 %), while the ASMBIA had the poorest sensitivity (30·5 %). All GLIM-based diagnostic methods correlated with malnutrition risk screening and nutrition status indicators. The GLIM criteria provide a standardised, clinically relevant approach for diagnosing malnutrition in hospitalised patients, with CC emerging as a highly sensitive assessment to examine muscle mass.
Coconut oil, extracted from coconut kernels, is a rich source of medium-chain fatty acids, including lauric acid, capric acid and caprylic acid. This experiment aimed to investigate the protective effect of coconut oil against intestinal injury induced by lipopolysaccharide (LPS) challenge in piglets. A total of twenty-four piglets were used in a 2 × 2 factorial experiment with dietary treatment (3 % soybean oil v. 3 % coconut oil) and LPS challenge (saline v. LPS). After 28 d of the experiment, piglets were injected intraperitoneally with LPS (100 μg/kg body weight (BW)) or saline. Piglets were slaughtered and sampled for testing. Pigs fed coconut oil had higher average daily gain and BW during the entire study. Supplementation with coconut oil improved intestinal morphology and barrier function, indicated by increased jejunal villus height, as well as enhanced protein expression of ZO-1 and Occludin. Furthermore, coconut oil supplementation improved plasma antioxidant capacity, indicated by enhanced GSH peroxidase activity and decreased malondialdehyde concentration. Moreover, coconut oil ameliorated the LPS-induced release of pro-inflammatory cytokines, as indicated by decreased IL-1β expression in the jejunum. Coconut oil also alleviated the up-regulation of the expression of necroptosis protein receptor-interacting protein kinase 3 and mixed lineage kinase-like protein in the jejunum of piglets stimulated by LPS. In conclusion, dietary supplementation of coconut oil can improve the growth performance of piglets and alleviate LPS-induced intestinal injury and inflammation by inhibiting necroptosis signalling pathway.
The Dutch Children’s Food Literacy Questionnaire (DCFLQ) was developed and validated to assess food literacy among children aged 8–12 years. The DCFLQ is structured around farm-to-fork principles, including questions on food production, distribution, consumption, waste, and sustainability.
Design:
After initial item pool creation, the DCFLQ was developed in collaboration with experts and children. The validation process included assessments of reliability and construct validity, as well as a test–retest evaluation in a subgroup of children.
Setting:
The expert panel consisted of domain-related researchers, a pedagogue, a paediatrician, dietitians and a primary school teacher. Children were recruited via primary schools and a sports club.
Participants:
A total of eleven experts and twenty-seven children participated in the development process; 608 children participated in the validation process.
Results:
The final questionnaire comprised twenty-nine questions and demonstrated good internal consistency (Cronbach’s α = 0·80) and test–retest reliability (ICC = 0·81). DCFLQ scores positively correlated with age, indicating that food literacy is higher in older children.
Conclusions:
The DCFLQ is a valuable tool for assessing the effectiveness of nutrition intervention programmes and monitoring Dutch children’s food literacy over time. International expert consensus on developing food literacy instruments is needed, as diversity in assessment tools impedes cross-cultural comparisons.
Autism spectrum disorder (ASD) has been frequently associated with an increased risk of obesity and metabolic disorders, including dyslipidaemia. However, research on lipid profiles and dietary intake in this population remains scarce. This cross-sectional study aimed to evaluate dietary patterns and their association with serum lipid profile in children and adolescents diagnosed with ASD. The study included 233 individuals from 2 to under 19 years assisted by the public health system in Pelotas, Brazil. Fasting blood samples were collected and analysed for serum concentrations of total cholesterol, HDL-cholesterol, LDL-cholesterol and TAG. Dietary intake was assessed using three non-consecutive 24-h food recalls (two weekdays and one weekend day). Dietary patterns were derived through reduced rank regression, using food group intakes as predictors and fibre density, energy density, carbohydrate and saturated fat intakes as response variables. Standardised pattern scores were calculated to assess individual adherence, and linear regression models, adjusted for potential confounders, were applied to examine the association between the dietary pattern scores and lipid profiles. Elevated TAG concentrations were observed in 48·9 % of the participants. Four dietary patterns were identified: Healthy, sugar and starches, mixed and dairy and biscuits. After adjustment, no significant associations were observed between dietary pattern scores and lipid profile. These findings underscore the complex nature of lipid metabolism in individuals with ASD and suggest that dietary patterns alone may not fully explain variations in lipid profiles. This reinforces the need for further research and development of appropriate nutritional interventions for this population.
The aim of this paper is to review the latest evidence on food reformulation as a public health policy to improve our understanding of how different policy designs can drive reformulation and influence food system change. The focus is on three key nutrients of concern – trans fatty acids, salt and sugar. In recent times, food reformulation has been categorised as either mandatory or voluntary, a distinction that can help assess policy effectiveness. However, this binary classification oversimplifies a far more complex policy landscape. Some policies, whether mandated by government or voluntarily suggested to industry, are explicitly intended to trigger reformulation. In contrast, others, may have never been designed with the intention to encourage reformulation but have nonetheless prompted significant changes in product composition, intake and potential health outcomes. Within what is commonly described as mandatory reformulation, for example, we find a broad mix of policy tools that operate very differently. Some, such as the UK’s Soft Drinks Industry Levy, were deliberately created to incentivise reformulation by applying financial pressure. Others, including front of pack nutrition labelling systems (particularly warning labels) and school food standards have encouraged reformulation only as a positive unintended consequence. These indirect drivers are not always evaluated for their impact on reformulation, which may lead to an incomplete understanding of their contribution to reducing intake of nutrients of concern and improving health outcomes. Nevertheless, emerging evidence suggests no single policy encourages reformulation alone, instead a combination of approaches are likely to drive it and contribute to meaningful and sustained food system change.
To evaluate eligibility and participation in nutrition assistance programmes (Supplemental Nutrition Assistance Program (SNAP) and Women, Infants and Children (WIC)) among transgender and gender diverse (TGD) adults in the USA and to capture their experiences when accessing food benefits.
Design:
This was a cross-sectional analysis of the US Transgender Survey (USTS) dataset – the largest survey of TGD adults in the US SNAP and WIC participation and experiences when visiting the public assistance office were reported using descriptive statistics; stratified analyses were conducted based on race using multivariate logistic regression modelling.
Setting:
The USTS was completed electronically in the USA.
Participants:
27 715 TGD adults.
Results:
Approximately 40·9 % of the full sample were SNAP eligible, yet only 30·6 % of those eligible were receiving the benefit; 0·45 % of the sample reported receiving WIC. TGD adults avoided the public assistance office because they feared being mistreated (3·2 %), were identified as transgender (46·2 %), were denied equal treatment (6·5 %) or were verbally harassed (5·2 %). People of colour were more likely to be denied equal treatment and verbally harassed at the public benefits office than their white peers. The impact of age, education level, employment status, relationship status and census region varied within each racial group.
Conclusions:
Far more TGD adults need food assistance compared with the general population, yet fewer are receiving the benefit. Culturally informed interventions are urgently needed to resolve the root causes of food insecurity, increase SNAP participation and address the negative experiences of TGD adults when accessing food benefits.