Using a Household Food Inventory to Assess Food Variety and Availability Among Mothers in Residential Substance Abuse Recovery Programs

Abstract

Obesity and substance abuse are two major public health issues in the United States, especially among low-income individuals. The United States Department of Health and Human Services has set forth the Dietary Guidelines, which encourage a diet rich in fresh fruits, vegetables, whole grains, legumes, lean meat, and low-fat dairy to help Americans obtain a healthy body weight. Substance abusers in recovery are at increased risk of weight gain, as their previous addiction may continue with the substance shifting from drugs or alcohol to sugary or high fat food. Nutrition interventions have been beneficial in recovery by improving outcomes and preventing relapse, however, possible barriers to obtaining fresh, healthy food items have been noted. There is limited research investigating females, especially mothers, in recovery and their access to healthy food items. The current study utilized a demographic survey and multiple Household Food Inventories (HFI) to assess the amount and variety of food items of mothers and their children in a residential substance abuse recovery facility. A sample of 11 mothers in rural, eastern North Carolina completed the survey and two separate HFI, two weeks apart to account for intra-monthly variability. Demographic information was entered into Statistical Package for the Social Sciences [SPSS] while HFI data were coded and categorized in Microsoft Excel. Results included all 11 mothers participated in at least two different federal food assistance programs, stated they face challenges grocery shopping, and seven households were food insecure. Fresh vegetables were slightly more common in households than fresh fruits, and canned, frozen, and packaged fruits (especially fruit juice), vegetables, and legumes, were more prevalent than fresh forms. Cheese was the most popular form of dairy, and most was full fat. The majority of protein was red meat or breakfast meat including bacon and sausage. Whole grain was less common than white, refined grain products. There was an abundance of pre-packaged, convenience food including chips, ice cream, cookies, and cakes. The results indicated that the HFI on two separate occasions was beneficial to explain variability among types and amounts of food items from one assessment to the next, especially among fresh fruits, fresh vegetables, and chicken. The lack of fresh fruits, vegetables, low-fat dairy options, lean meats, and whole grains in combination with copious sweetened, pre-packaged, high-fat food items form a diet associated with obesity and contradictive of the Dietary Guidelines. Possible barriers to obtaining healthier food options may include low or fluctuating income and federal assistance benefits, limited transportation, decreased storage space, infrequent grocery trips, or a lack of nutritional knowledge. Mothers and children in recovery could benefit from nutrition education and improved access to healthier food items. Future research should further investigate the barriers to obtaining fresh, healthy food items, as well as shifts in addiction from substance to food, food choice, disordered eating patterns, and subsequent weight and health issues to guide nutrition interventions for mothers and children in substance abuse recovery facilities.