Abstract
OBJECTIVE: To investigate the association between food insecurity (FI) and diet quality in private sector service workers. DESIGN: Data were collected via electronic questionnaires (2019) and the national register data (2018-2019). FI was measured using the Household Food Insecurity Access Scale (HFIAS) and diet quality using an FFQ and a modified Healthy Food Intake Index (mHFII). The associations between HFIAS and mHFII were studied using ANOVA and ordinal regression analysis. SETTING: Cross-sectional survey and register data for all municipalities in Finland in 2018-2019. PARTICIPANTS: Individuals (n 6435) belonging to the Finnish Service Union United. The members are predominantly women and work mainly in retail trade, tourism, restaurant and leisure services, property maintenance and security services. RESULTS: Overall diet quality, measured by mHFII, was significantly lower in those experiencing severe FI than in those who were food secure (8·0 v. 9·1). Additionally, those with severe FI were less likely to have higher (more optimal) scores in sugar-sweetened beverages (OR: 0·67), fibre-rich grains (OR: 0·79), vegetables (OR: 0·54), fruits and berries (OR: 0·61), vegetable oil (OR: 0·80), fish (OR: 0·65), milk (OR: 0·89) and nuts and seeds (OR: 0·66) than food-secure participants. Severe FI was associated with higher odds for less frequent consumption of red and processed meat (OR: 1·15, a higher score represents less frequent consumption). CONCLUSIONS: Severe FI was linked to both lower overall diet quality and suboptimal consumption of several food groups. Individuals experiencing severe FI may be predisposed to accumulating dietary risk factors for chronic diseases.