To determine the characteristics of US low-income households that use alternative food acquisition strategies and to examine the association between food security and alternative food acquisition.

Cross-sectional analysis. The ten-item Adult Food Security Survey Module was used to determine food security status. Self-reported data were used to determine food acquisition from community food sources, social networks and household food production.

The National Food Acquisition and Purchasing Survey (FoodAPS), 2012.

The sample consisted of 2534 low-income households (≤185 % of the federal poverty line) in the USA.

Households using alternative food acquisition strategies were more likely to have a primary respondent who was non-Hispanic White, born in the USA, and female, and more likely to live in a rural area, have higher income and own a home than households not using alternative acquisition strategies. Very low food security was positively associated with the use of community food sources (aOR = 2·26 (95 % CI 1·15, 4·46)). There was no association between food security and food acquisition from social networks or household food production.

Use of alternative food acquisition strategies varied by specific demographic characteristics among low-income households, suggesting opportunities for outreach and promotion of alternative acquisition strategies in specific subpopulations in the USA. Future research should examine whether quantity and quality of food received from these sources are associated with food security.

To determine whether residence in a US Department of Agriculture-designated food desert is associated with perceived access to healthy foods, grocery shopping behaviours, diet and BMI among a national sample of primary food shoppers.

Data for the present study came from a self-administered cross-sectional survey administered in 2015. Residential addresses of respondents were geocoded to determine whether their census tract of residence was a designated food desert or not. Inverse probability of treatment-weighted regression was used to assess whether residence in a food desert was associated with dependent variables of interest.

USA.

Of 4942 adult survey respondents, residential addresses of 75·0 % (n 3705) primary food shoppers were included in the analysis.

Residence in a food desert (11·1 %, n 411) was not significantly associated with perceived access to healthy foods, most grocery shopping behaviours or dietary behaviour, but was significantly associated with primarily shopping at a superstore or supercentre v. a large grocery store (OR = 1·32; 95 % CI 1·02, 1·71; P = 0·03) and higher BMI (b = 1·14; 95 % CI 0·36, 1·93; P = 0·004).

Results suggest that food desert residents shop at different food stores and have higher BMI than non-food desert residents.

To document food acquisition experiences during Iraqi military occupation in Kuwait.

Retrospective cross-sectional study.

Urban areas in Kuwait during occupation.

Those living in Kuwait during the period of occupation, and aged between 15 to 50 years at the time of occupation, recruited by snowball sampling. A total of 390 completed questionnaires (response rate 78 %, 202 female and 188 male) were returned.

During the occupation, food became increasingly difficult to acquire. Two food systems emerged: (i) an underground Kuwaiti network linked to foods recovered from local food cooperatives and (ii) a black market supplied by food imported through Iraq or stolen locally. Food shortages led to reductions in meal size and frequency. Some respondents (47·7 %) reported not having sufficient income to purchase food and 22·1 % had to sell capital items to purchase food. There was a significant increase (P<0·01) in home production, with 23·1 % of people growing vegetables and 39·0 % raising animals to supplement food needs. Reduction in food wastage also emerged as a significant self-reported behaviour change. Respondents reported deterioration in the quality and availability of fish, milk, and fruit in particular. Despite a decrease in opportunities for physical activity, most respondents reported that they lost weight during the occupation.

Although the Kuwaiti population fell by about 90 % and domestic food production increased during the 7-month occupation, the local population continued to rely heavily on imported food to meet population needs. The high prevalence of self-reported weight loss indicates the inadequacies of this food supply. High apparent food security in systems which significantly exceed the ecological carrying capacity of the local environment and rely on mass food importation remains vulnerable.