Food insecurity in Denmark-socio-demographic determinants and associations with eating- and health-related variables.

Background: Food insecurity and its consequences have not received much attention in the Nordic, social-democratic welfare states. This study reports the prevalence of low and very low food security in Denmark, identifies its socio-demographic determinants and examines its associations with eating-related and health-related outcomes.

Methods: A cross-sectional survey with a mixed-mode response format (telephone interviewing or Internet). A disproportional stratified random sampling design was employed (N = 1877). Main measure was the 6-item gradient food security construct adapted from the US.

Results: Prevalence of low and very low food security was 6.0% (95% CI:5.4-8.5%) and 2.4% (95% CI:1.3-3.3%), respectively. Prevalence was highest in households with disposable income below OECD's poverty threshold, households receiving benefits or disability pensions, and single-parent households. After socio-demographic adjustment, adults from low/very low food secure households had a higher probability of eating an unhealthy diet (women: adj.RR 2.82 P < 0.001; men: adj.RR 2.15 P < 0.01). Adults from low/very low food secure households had lower life satisfaction (women: adj.RR 0.49, P < 0.05; men: adj.RR 0.09 P < 0.001) and higher risk of psychological distress (women: adj.RR 2.42 P < 0.05; men: adj.RR 8.95 P < 0.001). Obesity was more prevalent in low/very low food secure women (RR 2.44 P < 0.05), but not after socio-demographic adjustment.

Conclusion: Food insecurity in Denmark is associated with adverse factors such as unhealthy diet, obesity, life satisfaction, and psychological distress. It is important to widen food insecurity research to non-liberal welfare states since low/very low food security is negatively associated with unhealthy eating and other health indicators, even in a social-democratic welfare state.