by Aliza Becker, BA, MPS
A variety of factors are known to influence our individual nutrition choices. As such, malnutrition may develop in response to external influencers in the surrounding environment, demographics, lifestyle choices, and congenital conditions alike.
Originating as a concept in Scotland in the 1990s, a “food desert” is a geographic area with insufficient access to affordable and nutritious food, often due to the combined lack of supermarkets and a preponderance of fast food options.1 They are more often found in low-income and rural areas and provide residents with inadequate or poor food choices.2 Living in a food desert census district compared to a non–food desert census district in the United States (US) can increase the odds of obesity by 30 percent.3 Meanwhile, food insecurity, defined by the US Department of Agriculture as a “reduced quality, variety, or desirability of diet” or “multiple indications of disrupted eating patterns and reduced food intake”2 (which may occur among those living in food deserts), is associated with stunted growth among children in lower-middle– and upper-middle–income countries (but overweightness among girls in middle- and high-income countries), low birth weight in infants, and anemia in women.4
Of note, individuals experiencing food insecurity may be ultimately at greater risk for the development of hypertension, diabetes, and other chronic conditions due to their nutrition-poor diet.5 International variations in the differences in cost of a calorie between healthy and unhealthy foods also serve to exacerbate nutrition-related health issues on a global scale.6 For example, calories from eggs are 23.3 times more expensive than those from staple foods such as rice, bread, and corn in Niger, but only 1.6 times as expensive in the United States.7
A variety of demographic and lifestyle-related factors may affect nutrition. One Spanish study reported that less-educated individuals; those who are current smokers; those who are less physically active; and those who are single, divorced, or separated are less likely to adhere to a Mediterranean dietary pattern, considered by the study authors to be an ideal model for food choices.8 In Portugal, researchers found that smokers also had a higher intake of alcoholic beverages and a lower consumption of food items rich in fiber, antioxidants, and phytochemicals.9
Among Americans, children and older adults had better-quality diets than younger and middle-aged adults, women had better-quality diets than men, and Hispanics had better-quality diets than either blacks or whites.10 In the context of employment, shift workers may be at greatest risk for an unhealthy diet, including greater consumption of saturated fats and soft drinks,11 while people who are either self-employed, civil servants, have a permanent contract, or are a noncontracted worker and those who are physically active during their main job tend to have a higher quality of diet.12 In children, parents influence food preferences and eating behaviors by making some foods available to their children over others and by acting as models of eating behavior, which can have lifelong implications.13
Hereditary conditions can necessitate the avoidance of certain foods, leading to nutritional deficiencies.Ffor example, people with celiac disease on an established gluten-free diet may have insufficient intake of iron, zinc, and vitamins D and B6,14 while those with irritable bowel syndrome may have a zinc deficiency due to avoiding milk as a trigger food.15
As such, it is clear that there is no one-size-fits-all approach to eating for everyone. In response, the concept of personalized nutrition first emerged in the 1940s before gaining steam in 2003,16 and interest has only grown since then, especially as new findings in the fields of genetics and food analytics have been made.17 Today, beyond tailoring nutrition plans to the needs of special populations, such as pregnant or lactating women, athletes, or people with certain chronic or hereditary diseases, the field of personalized nutrition seeks ultimately to consider individuals’ genetic, phenotypic, medical, nutritional, and other relevant information to design unique plans for healthy eating, disease avoidance, and well-being.17
1. Beaulac J, Kristjansson E, Cummins S. A systematic review of food deserts, 1966–2007. Prev Chronic Dis. 2009;6(3):A105.
2. Dutko P, Ver Ploeg M, Farrigan T. Characteristics and influential factors of food deserts. https://www.ers.usda.gov/webdocs/publications/45014/30940_err140.pdf. Accessed March 17, 2022.
3. Chen D, Jaenicke EC, Volpe RJ. Food environments and obesity: household diet expenditure versus food deserts. Am J Public Health. 2016;106(5):881–888.
4. Maitra C. A review of studies examining the link between food insecurity and malnutrition. https://www.fao.org/3/CA1447EN/ca1447en.pdf. Accessed March 17, 2022.
5. Seligman HK, Laraia BA, Kushel MB. Food insecurity is associated with chronic disease among low-income NHANES participants. J Nutr. 2010;140(2):304–310.
6. Headey DD, Alderman HH. The relative caloric prices of healthy and unhealthy foods differ systematically across income levels and continents. J Nutr. 2019;149(11):2020–2033.
7. Headey DD, Alderman HH. Why living in a poor country means you have bad food choices. https://theconversation.com/why-living-in-a-poor-country-means-you-have-bad-food-choices-121993. Accessed March 17, 2022.
8. Hu EA, Toledo E, Diez-Espino J, et al. Lifestyles and risk factors associated with adherence to the Mediterranean diet: a baseline assessment of the PREDIMED trial. PLoS One. 2013;8(4):e60166.
9. Padrão P, Lunet N, Santos AC, Barros H. Smoking, alcohol, and dietary choices: evidence from the Portuguese National Health Survey. BMC Public Health. 2007;7:138.
10. Hiza HAB, Casavale KO, Guenther PM, Davis CA. Diet quality of Americans differs by age, sex, race/ethnicity, income, and education level. J Acad Nutr Diet. 2013;113(2):297–306.
11. Souza RV, Sarmento RA, de Almeida JC, Canuto R. The effect of shift work on eating habits: a systematic review. Scand J Work Environ Health. 2019;45(1):7–21.
12. de la Cruz SP, Cebrino J. Trends in diet quality and related sociodemographic, health, and occupational characteristics among workers in Spain: results from three consecutive National Health Surveys (2006–2017). Nutrients. 2021;13(2):522.
13. Savage JS, Fisher JO, Birch LL. Parental influence on eating behavior: conception to adolescence. J Law Med Ethics. 2007;35(1):22–34.
14. Kreutz JM, Adriaanse MPM, van der Ploeg EMC, Vreugdenhil ACE. Narrative review: nutrient deficiencies in adults and children with treated and untreated celiac disease. Nutrients. 2020;12(2):500.
15. Hujoel IA. Nutritional status in irritable bowel syndrome: a North American population-based study. JGH Open. 2020;4(4):656–662.
16. Bland JS. The evolution of personalized nutrition—from Addis, Pauling, and RJ Williams to the future. Integr Med (Encinitas). 2019;18(6):10–13.
17. Chaudhary N, Kumar V, Sangwan P, et al. Personalized nutrition and -omics. In: Cifuentes A. Comprehensive Foodomics. Amsterdam, Netherlands: Elsevier; 2021: 495–507.
About the Author
Ms. Becker is the managing editor of The Journal of Innovations in Cardiac Rhythm Management. She also works as a freelance editor and as a teaching assistant for the George Washington University’s Master of Professional Studies in Publishing program.