How Is U.S. Food-Insecurity Related to Dietary Quality? A Scoping Review to Inform Nutrition Security Across the...

Background/Objectives: This review examined how different levels of U.S. food-security (FS) relate to dietary markers, informing the concept of nutrition security over the lifespan. Methods: The authors followed PRISMA-ScR guidelines. PubMed, CINAHL, Scopus, Embase, and CAB Abstracts were searched for eligible U.S.-based, English-language studies examining FS and dietary markers in free-living, disease-free populations, excluding COVID-19-era research. Two reviewers independently screened records in Covidence, with discrepancies resolved by a third reviewer. The percentage of studies evaluating >2 FS levels was determined. Dietary markers were classified into three domains: food and beverage (9 components), nutrient (16 components) and bioactive (2 components) markers. The percentages of studies with significant differences were estimated for each dietary domain. Results: Of 1069 records, 78 met full-text eligibility. Among these, 15% evaluated dietary markers across >2 FS levels. Among adults, differences by FS status were observed in 67% of assessed food and beverage components (6 out of 9), 50% of nutrient components (8 out of 16), and all evaluated bioactives (100%; 2 out of 2). Children exhibited differences in all assessed food and beverage components (100%; 9 out of 9) and 29% (2 out of 7) of nutrients by FS level. Adolescents had fewer dietary marker differences than children and adults. Findings among infants, pregnant women and older adults were limited, with no studies for lactating women. Conclusions: Low FS level is associated with poorer dietary markers across the lifespan compared with FS. Age-specific differences highlight the need for targeted interventions and nutrition security measures.