foods

Review
Measuring Food Insecurity: The Problem with Semantics
Rachel M. Sumsion, Haylie M. June and Michael R. Cope *

Department of Sociology, Brigham Young University, Provo, UT 84602, USA; rm553@[Link] (R.M.S.);
hjune@[Link] (H.M.J.)
* Correspondence: michaelrcope@[Link]

Abstract: Rising rates of hunger and food insecurity have sparked a major re-evaluation of all aspects
of food systems. Because of the multifaceted nature of food insecurity, however, determining what
actions should be taken is challenging, especially since reevaluation efforts are led by experts from
several disciplines and there is no consensus about which indicators should be used and how they
should be measured. Confusion surrounding the meaning of the terms ‘food security’ and ‘food
insecurity’ has contributed to this lack of consensus. As indicators inform action, such confusion
has slowed those committed to alleviating hunger in identifying the most pressing targets. This
review highlights (1) the importance of clearly defining food security and food insecurity and (2) how
such definitions affect measures of food insecurity in the United States. While some might say that
definitions are an issue of the past or a trivial matter of semantics, we believe that the world’s present
rates of hunger and malnutrition are attributable, at least in part, to the lack of consensus on these
definitions and their accompanying measurements and indicators. Although the present review can
be helpful to academics and policy makers, the primary purpose is to be a resource to those involved
in the day-to-day production of food, such as ranchers and farmers by providing an overview of
definitions, indicators, and measurements used when discussing food security.

Keywords: food insecurity; food security; measurement; hunger; levels of analysis

1. Introduction
Citation: Sumsion, R.M.; June, H.M.; The right to food has been recognized as an international human right for almost
Cope, M.R. Measuring Food 75 years [1]. Since the 1950s, dozens of organizations have worked to alleviate hunger and
Insecurity: The Problem with improve food systems and access to food [2]. However, despite these efforts, progress in
Semantics. Foods 2023, 12, 1816. combatting hunger and food insecurity has stalled and, in some cases, even been reversed
[Link] in recent years due in part to the COVID-19 pandemic and Russian–Ukrainian conflict.
foods12091816 Indeed, “after remaining relatively unchanged since 2015 . . . the number of people affected
Academic Editors: Raquel P. F. Guiné by hunger since (2019 grew) by about 150 million” [3]. In 2020, an estimated 828 million
and Theodoros Varzakas people went hungry [3], prompting researchers and policymakers to re-evaluate global
food systems [4]. Unfortunately, progress in such efforts has been slowed, however, due to
Received: 22 March 2023
various understandings of the terms ‘food security’ and ‘food insecurity’ as well as their
Accepted: 20 April 2023
accompanying indicators.
Published: 27 April 2023
Research on food insecurity spans a variety of disciplines. Agriculturists, anthropolo-
gists, economists, nutritionists, sociologists, and others have all made valuable contribu-
tions on the subject [5]. The value of these multidisciplinary efforts cannot be understated;
Copyright: © 2023 by the authors.
however, significant variation exists between each discipline’s definitions and methods
Licensee MDPI, Basel, Switzerland. of measuring food security. Despite international consensus supposedly being reached in
This article is an open access article 1996 on the definition of food security (the 1996 World Food Summit definition of food
distributed under the terms and security (updated in 2009) is: “Food security exists when all people, at all times, have
conditions of the Creative Commons physical, social and economic access to sufficient, safe and nutritious food to meet their
Attribution (CC BY) license (https:// dietary needs and food preferences for an active and healthy life” [2]), many definitions
[Link]/licenses/by/ of ‘food security’ and ‘food insecurity’ are still commonly used and propagated today
4.0/). between and within disciplines. As definitions precede measurements, measurements

Foods 2023, 12, 1816. [Link] [Link]

Foods 2023, 12, 1816 2 of 21

produce indicators, and indicators inform action, this is problematic [6]. Comprehensive,
valid measurements of food security are needed to ensure accuracy in current and future
projections of food insecurity. Such measurements are built upon a foundation of common
definitions. This review serves as a call to reestablish consensus in the definitions and
measures of food security and insecurity as without agreement on who is experiencing
food insecurity, where they are located, when they are most vulnerable, or why they are
experiencing it, little can be done to effectively combat it [6].
This paper presents an overview of food security/insecurity, by summarizing current
and common definitions of the terms, as well as different indicators and measurements
of said indicators. It highlights notable similarities and differences between definitions
and makes recommendations for a renewed focus to be placed on the use of consistent
definitions between and within disciplines. Following this semantic overview, we illustrate
how different definitions of food security and insecurity affect measurements and indicators
of the topic in the United States. To conclude, we recommend that standardized definitions
are reviewed and reemphasized.
Although some experts may say that definitions are an issue of the past or that this
topic should be left to semanticists, we believe that the world’s tragic rates of hunger and
malnutrition are partially attributable to the confusion surrounding what ‘food insecurity’
is and how to measure it [7]. The current paper contributes to the literature by providing a
comprehensive review of the language of ‘food insecurity’ [8]. While the current paper can
be useful to academics across disciplines and to policy makers, the primary audience of
the paper are members of communities that contribute to food production on a day-to-day
basis, such as farmers and ranchers. We believe that providing a comprehensive review for
this audience can be used to inform policy, help those in food production receive needed
government grants, and ultimately help alleviate food insecurity.

2. Review
2.1. Why Food Insecurity?
Since 1948, the right to food has been internationally recognized as a basic human
right [9]. Despite a broad consensus about what this means, together with many valiant
efforts to combat malnutrition in all its forms, it is estimated that over 820 million people
worldwide go hungry and around 2 billion people experience food insecurity each year [4,10,11].
Food insecurity is a serious issue as it is related to a variety of adverse physical, mental, and
social health outcomes for both adults and children. Adults who experience food insecurity
are more likely to contract noncommunicable diseases (such as diabetes, hypertension,
hyperlipidemia, or chronic heart disease), have a reduced fertility rate, a decreased basal
metabolic rate, micronutrient deficiencies (particularly protein, Vitamin A, B Vitamins,
calcium, iodine, iron, and zinc), food allergies, or be overweight or obese [4,9,12–17].
Children experiencing food insecurity have higher rates of cognitive, behavioral, and social
problems, and are more likely to be stunted, wasted, have poor oral health, anemia, asthma,
or suicidal ideations [8,13,15,18–20]. These adverse effects, along with others, have been
linked to people experiencing food insecurity spending over USD 1860 more per capita
annually on healthcare than people who are food secure [15]. In the most extreme cases,
food insecurity can lead to death for both children and adults.
In response to these grim findings, and in recognition that food security is one of the
world’s most pressing issues, government and food security experts have been meeting
for years to discuss hunger and food security [10,21]. Their combined efforts have helped
to reduce the number of those affected by hunger and malnutrition. In 2016, the United
Nations (UN) announced that its second Sustainable Development Goal was to “end
hunger, achieve food security and improve nutrition and promote sustainable agriculture”
by 2030. To do so, they planned to double small farmers’ productivity and incomes, increase
agriculture investment, and ensure food markets’ proper functioning [15,22]. While the
UN’s inspiring goal invigorated efforts to improve food systems, and a significantly larger
number of studies on food insecurity—including issues of sustainability, the environment,
Foods 2023, 12, 1816 3 of 21

socioeconomics, culture, politics, and governance—have been conducted over the past nine
years, rates of worldwide food insecurity have been on the rise since 2014 [4] with recent
reports projecting that nearly 670 million people will still be undernourished in 2030 [3].

2.2. Defining Food (In)Security

‘Hunger’ is a familiar, but multi-layered term [23]. In academia, scholars often refer to
it as the “painful or uneasy sensation caused by a lack of food” [24] (p. 1560) [25]. However,
due to its subjective nature, since 2006 there has been no officially recognized metric of
‘hunger’ [26]. Instead, researchers and policymakers measure the food security and food
insecurity of nations, regions, households, and individuals—levels of analysis which seldom
yield the same results. While ‘hunger’ and ‘food insecurity’ are not synonymous, they are
closely related, with hunger being a potential consequence of food insecurity [27,28].
Ironically, while measures of ‘hunger’ have been rejected for their subjectivity, the
concepts of ‘food security/insecurity’ are also defined and measured without objectiv-
ity [29]. While the terms have been around since the 1950s, they are understood and applied
differently according to the context and region in which they occur [30,31]. The term ‘food
security’ was first defined at the World Food Conference in 1974 as “(the) availability at
all times of adequate world food supplies of basic foodstuffs to sustain a steady expan-
sion of food consumption and to offset fluctuations in production and prices” [32]. As
understanding of the causes and consequences of food security/insecurity have shifted
and expanded since that time, however, definitions have continuously evolved. Food
security/insecurity has been described as a flexible, multidimensional concept, and has
been understood and applied differently by sociologists, agriculturists, political scientists,
nutritionists, and economists throughout the years [33,34]. In the past especially, various
viewpoints contributed to a “bewildering number of paradigms and points of view” in
the literature [9] (p. 50). For instance, in the 1990s, Smith, Pointing, and Maxwell said
that “there is no single definition (of food security or food insecurity) . . . but rather a
complex weave of inter-related strands which are adjusted to suit the needs and priorities
of individual users” [35] (p. 136). To illustrate their point, they compiled an annotated bibli-
ography of close to two hundred definitions of these terms and called for the development
of a comprehensive definition [35]. As a result, at the 1996 World Food Summit, a new
definition of food security was proposed and ratified [36], to which only minor adjustments
have been made since. The most recent agreed upon definition states that:
Food security exists when all people, at all times, have physical, social, and economic
access to sufficient, safe, and nutritious food that meets their dietary needs and food
preferences for an active and healthy life [36].
While this definition has largely been accepted and is used by most scholars well-
versed in the literature, definitions of food security and its counterpart, food insecurity,
still vary between disciplines and countries. For instance, while the Life Sciences Research
Office’s 1990 definition of food insecurity (food insecurity is the limited or uncertain
availability of nutritionally adequate and safe foods, or the limited or uncertain ability to
acquire acceptable foods in socially acceptable ways [24]) is often used in the United States,
it has not been widely adopted elsewhere.
While Smith et al.’s work helped clarify the concepts of food security and food insecu-
rity in the 1990s, a good number of definitions of the concepts are still used and propagated
today in academic as well as grey literature. Inspired by and drawing from the work of
Smith et al., Tables A1 and A2 illustrate the relevance of this issue as each of the 52 defini-
tions presented (19 for food security and 33 for food insecurity) have been cited as primary
definitions of the concepts in scholarly literature since 2000 (four years after the UN’s World
Food Summit definition was ratified to allow time for adoption). While we acknowledge
that the definitions of individual researchers unfamiliar with the semantic history of food
insecurity should not be given the same weight as definitions produced through more
intensive processes, we maintain that to non-academic audiences and/or those less familiar
with food security literature, the continued use of so many definitions can have negative
Foods 2023, 12, 1816 4 of 21

repercussions, especially since much of the nuance between these definitions is far from
insignificant when it comes to measuring food insecurity [9,10,35,37].

2.3. Varying Definitions of Food Security

If poor data leads to poor policies, then rising rates of food insecurity may be at-
tributable, at least in part, to a lack of consensus in the measures and corresponding
indicators of ‘food security’ and ‘food insecurity.’ Definitions, targets, and cut-off points
for indicators such as ‘adequate’, ‘sufficient’, ‘nutritious’, ‘acceptable’, or ‘preferred’ foods
vary from organization-to-organization, fragmenting the efforts of organizations commit-
ted to eradicate hunger, despite reaching a consensus during the World Food Summit in
1996 [7]. The World Food Summit definition has varying dimensions and while it is widely
adopted in the literature in the United States, consistent indicators and measurements
have not. To better inform policy decisions and develop more effective interventions, clear
data, indicators, and measurements are needed. Each of these aspects is dependent upon
sound definitions and clarity in regard to which specific dimensions of a definition are
being measured [38,39].
Without concretely defining the bounty of food security or the threat of food insecurity,
actionable solutions to the latter may remain out of reach [40]. We recognize that there
is danger in relying on a single definition as a “definition implies a choice, a particular
way of seeing a problem among a range of alternatives (and) policy is determined in part
by that choice” [41] (p. xii). Accordingly, some scholars plausibly argue that a single,
universal, “catch-all” definition does not adequately address the complexities of food
security or food insecurity [5,37,39,42,43] (p. 1023–1024). For this reason, multifaceted
definitions are needed to generate broad agreement among policymakers and practitioners
with diverse emphases. Without such agreement, inconsistencies will continue to exist
between various organizations’ measurements, policies, and actions [16]. Care should be
taken not to conflate ‘food security’ or ‘food insecurity’ with other terms. For instance, in
many cases, a ‘food security’ organization’s focus may be more appropriately described by
terms such as ‘nutrition security,’ ‘hidden hunger,’ ‘food insufficiency,’ ‘food access,’ ‘food
capacity,’ ‘food resilience,’ ‘food rights,’ or ‘food sovereignty’ [5,44,45]. Additionally, the
multi-dimensionality of food security should be recognized when developing and using
measurements for it [39].
For effective policies to be made, common measurements and agreed upon definitions
of ‘food security’ and ‘food insecurity’ are needed [8,38]. Tables A1 and A2 present many
definitions that have been used to describe these concepts. Most broadly accepted defini-
tions recognize that ‘food security’ and ‘food insecurity’ are multifaceted concepts. ‘Four
pillars’ are commonly agreed upon [8,46,47]: food availability (supply and production),
food access (economic and physical), food utilization (use), and food stability (consis-
tency) [15]. In recent years, calls to expand our conceptual definition of food security has
led to the proposal of two additional pillars: agency (empowerment in consumption and
production) and sustainability (long-term impacts) [37,48]. Despite such similarities, differ-
ences in aspects such as the level of analysis to which the definition applies, what is meant
by phrases such as ‘enough food,’ ‘adequate food,’ ‘preferred food,’ or ‘culturally or socially
acceptable means,’ and the relative importance or unimportance of self-perceptions impact
measurements, rates, and understandings of the severity of food security and insecurity.
Such differences are crucial for policymakers to be aware of and understand. We address
this point in the following section by exploring how definitional differences can lead to
variation in measures of food security/insecurity by implying different levels of analysis
and understandings of phrases.

2.3.1. Levels of Analysis

Although hunger is a state that is experienced on the individual level, food security
and food insecurity are often conceptualized at various levels of analysis [18,35]. The most
common levels of analysis are ‘global,’ ‘national,’ or ‘regional’ (which generally concern the
Foods 2023, 12, 1816 5 of 21

level and reliability of the availability of food supplies), ‘household’ (which generally means
the household’s economic, physical, or socio-cultural access to food), or ‘individual’ (often
someone’s economic, physical, or socio-cultural access and entitlement to food) [31,49].
Table 1 summarizes each of the levels of analysis.

Table 1. Levels of analysis.

Level of Analysis Description

Global Refers to the availability and reliability of food worldwide.
Refers to the availability and reliability of food at a national level, the production of food within countries,
National
and the levels of food reserves that should be maintained consistently.
Regional Refers to the availability and reliability of food at a regional level.
Refers to a household’s physical and economic access to food, their levels of vulnerability, and their
Household
utilization of food.
Refers to an individual’s physical and economic access to food (recognizing that food is not always evenly
Individual
distributed at the household level), their levels of vulnerability, and their utilization of food.
Note: The table gives descriptions of different levels in which experiencing hunger is measured.

Before the 1980s, food insecurity was considered almost exclusively at the global or
national level and was understood to be an issue of food supply; that is, the main driver
of food insecurity was thought to be the lack of food [48]. Consequently, most efforts to
address food insecurity focused on improving agricultural yields and regulating national
reserves. Over time, however, researchers recognized that the availability of food alone
was not sufficient to combat hunger. This fact was widely accepted in the early 1980s
with the publication of Amartya Sen’s Poverty and Famines in which he argued that a
lack of food entitlement—unequal access to food by production, trade, one’s own labor, or
transfers—not a lack of food itself, was a principal driver of food insecurity [50]. From this
time forward, “food access” which is measured at the household and individual level has
been recognized as a principal component of food security [9,50].
While progress has accompanied this analytical shift, choosing to operationalize food
security/insecurity at any given level of analysis requires making assumptions about
that level [9]. Consider the ‘household’ level of analysis. What is meant by ‘household’?
While it was originally intended to mean individual family units, today some consider any
occupants under a single roof, including non-family members such as tenants, boarders,
roommates, or other non-dependents as ‘household’ members.
Further, assuring that enough food is allocated at the household level does not neces-
sarily translate to people receiving enough food at the individual level as the distribution of
food within households can still be unequal to people’s specific needs [8,50]. For instance,
maternal buffering occurs when mothers consume less food to give their children more [1].
Such buffering, along with other similar coping strategies, would pass undetected if orga-
nizations solely relied upon household level measures. If organizations relied solely upon
individual level measures, however, they could fall victim to overestimating the severity of
such a family’s experience. Suffice it to say, in cases when levels of analysis are conflated,
rates of food insecurity can be over-or-under-exaggerated [50]. For this reason, deciding
what level of analysis the concepts of food security and insecurity are meant to refer to
might clarify the mission of organizations and effectively narrow their focus in helping
those experiencing food insecurity. Of course, the goal of doing so would not be to ignore
other levels of food security or insecurity, rather to clarify those that are most important to
organizations. Terms such as ‘food supply’ (global, national, or regional levels of analysis)
or ‘food access’ (household or individual levels of analysis) might be profitably used to
clarify these differences.

2.3.2. Same Words, Different Ideas

Cultural differences and expectations impact the interpretations of definitional con-
structs, or the different dimensions of a definition. In measuring food security and in-
security, these different understandings can have a significant impact on food security
Foods 2023, 12, 1816 6 of 21

data. For instance, what is meant by ‘enough’ or ‘sufficient levels’ of food significantly
affects reported rates of food insecurity. ‘Enough’ can refer to a variety of indicators such
as individual energy requirements (measured as calories or macronutrients (often revised
according to age, gender, and activity rates) [8] (p. 1), personal nutrition requirements
(measured in micronutrients; specifically, vitamin A, iron, and iodine [9]), or personal
perceptions (measured according to self-reported surveys [50]). Several of the variations in
how such indicators are used can be explained by the definitions influencing them. Some
definitions imply that ‘enough’ means a minimal level of food consumption (see 51–54),
others mean the amount of food required to meet nutritional needs (see 18, 24, 55–59), and
still others mean the amount necessary to live an “active, healthy life” (see 2, 26, 24, 50,
60–67) (see Table 2).

Table 2. Different Interpretations of ‘Enough’.

Citation Definition
Minimal levels of food consumption
Alamgir and Arora 1991 [51] The sum of household and sub-national food security, and more. At the national level, food
security can be defined as assured national availability of food to meet current minimum
requirements per capita during a reference period (normally, one year) and, also, to meet any
unexpected shortfall over a limited period (e.g., three months).
IFAD, 1991 [52] Access to enough food to ensure the minimum necessary food intake for all individual members
to lead a healthy life.
Siamwalla and Valdes 1980 [53] The ability to meet target levels of consumption on a yearly basis.
World Bank Staff, 1980 [54] The assurance of a minimally adequate level of food consumption.
Necessary to meet nutritional needs
Alaimo, 2005 [18] Food insecurity: limited or uncertain availability of nutritionally adequate or safe foods.
Barraclough and Utting 1987 [55] Assured access by all social groups and individuals to food adequate in quality and quantity to
meet nutritional needs.
Benson et al., 1986 [56] Having assured sets of entitlements—from food production, cash income, reserves of food or
assets, and/or government assistance programs—such that in times of need people will be
able to maintain sufficient nutritional intake for physical well-being.
Eicher and Staatz, 1986 [57] The ability of a country or region to assure, on a long-term basis, that its food system
provides the total population access to a timely, reliable, and nutritionally adequate supply
of food.
Jonsson and Toole, 1991 [58] Access to food, adequate in quantity and quality, to fulfill all nutritional requirements for all
household members throughout the year.
Life Sciences Research Office and Andersen, Food insecurity: the limited or uncertain availability of nutritionally adequate and safe foods
1990 [24] or limited or uncertain ability to acquire acceptable foods in socially acceptable ways.
Winne et al., 2000 [59] All persons in a community have access to culturally acceptable, nutritionally adequate food
through local non-emergency sources at all times.
The amount of food needed for an “active, healthy life”
Bartfeld and Dunifon, 2006 [60] The assured access of all people to enough food for a healthy and active life.
Coleman-Jensen et al., 2021 [61] Consistent, dependable access to enough food for active, healthy living.
FAO et al., 2009 [2] Food security exists when all people, at all times, have physical, social, and economic access
to sufficient, safe, and nutritious food that meets their dietary needs and food preferences for
an active and healthy life.
Haddad et al., 1995 [62] Availability of sufficient food at all times for all people to ensure an active and healthy life.
Hayes, 2021 [26] Consistent access to enough food for active, healthy lives for all household members at all times
during the year.
Kabeer, 1990 [63] The ability of a household to assure all its members sustained access to sufficient quantity and
quality of food to live active, healthy lives.
Life Sciences Research Office and Andersen, Access by all members at all times to enough food for an active, healthy life. Food security
1990 [24] includes at a minimum:the ready availability of nutritionally adequate and safe foods;
assured ability to acquire acceptable foods in socially acceptable ways (i.e., without resorting
to emergency food supplies, scavenging, stealing, or other coping strategies).
Pinstrup-Andersen, 2009 [50] Access by all people to enough food to live a healthy and productive life.
Reutlinger, 1985 [64] Access by all people at all times to enough food for an active and healthy life.
Reutlinger, 1986 [65] Access by all people at all times to enough food for an active, healthy life.
United Nations, 1990 [66] The ability of household members to assure themselves sustained access to a sufficient
quantity and quality of food to live active, healthy lives.
World Food Program, 1996 (2009) [67] When all people, at all times, have physical and economic access to sufficient, safe and
nutritious food that meets their dietary needs and food preferences for an active and
healthy life.
Note: The table gives definitions and citations of different interpretations of ‘enough’ in the literature.
Foods 2023, 12, 1816 7 of 21

Similar analyses of definitional constructs such as ‘adequate foods’, ‘preferred foods’, and
‘culturally or socially acceptable means’ are also important to understand (see Tables A3–A5).
Although some scholars have made efforts to clarify these constructs (for instance, Pinstrup-
Andersen defines ‘preferred foods’ as “foods that are socially and culturally acceptable and
consistent with religious and ethical values” [50] and Frongillo and Horan define ‘socially
unacceptable means’ as “buying food on credit, using food pantries, or . . . asking friends
and relatives for money for food” [47] (p. 30), most definitions lack such specification. We
believe that each of these constructs needs clarifying to be of value to policymakers. In their
present form, they are largely subjective, and their applications vary significantly between
contexts [39]. This presents difficulties in developing comparable measurements and
coordinated plans for action. By finding common ground for definitions and measurements,
a more comprehensive understanding of food security and food insecurity will emerge and
lead to meaningful progress in combatting world hunger.

2.4. Measuring Food Security

Measures of food security are continually being refined and improved, even though
scholars generally agree than food security rests on the four pillars of availability, access,
utilization, and stability [37,48,68]. In 2006, Webb et al. identified that many measurements
were (1) shifting their focus from measures of availability and utilization to measures of
access, (2) shifting from objective to subjective measures, and (3) placing more of an em-
phasis on direct rather than proxy measures of food security [69]. In 2012, the Committee
on World Food Security recommended that all measurements of food insecurity be based
on human rights, ensure accountability, involve all relevant stakeholders, be easily under-
standable, and build upon rather than duplicating national capacities [68]. Recently, some
food security definitions have expanded to include agency and sustainability as pillars to
understanding the right to food [37,48].
Some of the most widely recognized measures of food security in the United States
today include Anthropometric measures, Coping Strategies Index (CSI), Domestic Food
Price Volatility, Food Consumption Score (FCS), Food Insecurity Experience Scale (FIES),
Global Food Security Index (GFSI), Global Hunger Index (GHI), Household Consumption
and Expenditure Surveys (HCES), Household Dietary Diversity Score (HDDS), Household
Food Insecurity Access Scale (HFIAS), Household Pulse Survey (HPS), Months of Ade-
quate Food Provisioning (MAHFP), Prevalence of Undernourished (PoU), and the Relative
Dietary Supply Index (see Table 3). Each of these indicators assess slightly different aspects
of food security. For instance, while some of these indicators focus on macro-measures
at the global, national, or regional levels of analysis, others focus on micro-measures at
the household and individual levels. Consequently, different measures prioritize selective
pillars of food security as food supply (availability) is typically measured on a macro-scale
while economic or physical access, dietary diversity (utilization), and coping strategies
(stability) are typically measured on micro-scales [5,70]. Every indicator yields important
insights, but sizeable gaps remain between the multifaceted nature of food security and
what existing measurements reveal about the concept [39,41]. As the concept of food
security has begun to be expanded to include sustainability and agency, questions about
measurements of these indicators have been brought up [37].
Foods 2023, 12, 1816 8 of 21

Table 3. Measures of food security in the United States (2022).

Measure Description
Anthropometric measures Measures bodily characteristics such as height, weight, skinfold, etc.
(combined with weight and age) to assess the utilization of food [5]
Coping Strategies Index (CSI) Measures the frequency and severity of context specific behaviors taken
in response to food insecurity [5]
Domestic Food Price Volatility Measures the variability in the annual food price index [5]
Food Consumption Score (FCS) Measures the quality, quantity, and diversity of foods consumed by a
household in the last seven days [70]
Food Insecurity Experience Scale (FIES) Measures the severity of food insecurity in population groups based off
individual or household level data [68]
Global Food Security Index (GFSI) Measures the affordability, availability, quality, resiliency, and safety of
available foods in given nations [15]
Global Hunger Index (GHI) Measures rates of undernourishment, underweight children, and child
mortality at the national level to assess hunger [68,70]
Household Consumption and Expenditure Measures a variety of household socioeconomic conditions affecting food
Surveys (HCES) security such as food acquisition and consumption [5]
Household Dietary Diversity Scores (HDDS) Measures the number of food groups (grains, starches, vegetables, fruits,
meat, eggs, fish, legumes, dairy, fats, sugar, condiments, etc.) consumed
by an individual or household in the previous 24 h [71]
Household Food Insecurity Access Scale (HFIAS) Measures the frequency and intensity of challenges that households face
in accessing food [71]
Household Food Security Survey Module (HFSSM) Measures the prevalence of food insecurity among households in the
United States [49]
Household Pulse Survey (HPS) Measures household sufficiency of food in the last 7 days, 2 weeks, or
month based off a single question [26,28]
Months of Adequate Food Provisioning (MAHFP) Measures a household’s stability in maintaining adequate levels of food
in the past year [5,71]
Prevalence of Undernourished (PoU) Measures the percentage of a country’s population whose typical food
intake is below the levels needed for an active and healthy life using
national estimates [68,72]
Relative Dietary Supply Index Compares the available dietary energy supply in a country with that
country’s average caloric needs [5]
Sustainable Nutrition Security (SNS) Incorporates metrics of sustainability [73]
Women’s Empowerment Nutrition Grid (WEN Incorporate agency, alongside knowledge and resources, as dimensions
or WENI) of empowerment with respect to food security [37,74,75]
Note: The table gives measures and their descriptions of food security in the United States.

As no single measure is adequately represents all aspects of food insecurity, many

organizations have begun triangulating their use of measurements and indicators [68,71].
Some have found value in utilizing indirect measurements such as food balance sheets,
temperature, rainfall, marketing data, political instability, trade policies, or household size
and dependency ratios to capture the concept more fully [1,5,39]. Unfortunately, some
have erroneously used measurements interchangeably, failing to recognize that not all
methods capture the same thing [5,39]. To tackle this issue, some have recommended that
interchangeable measures of food security be developed [71].

2.5. Common Measures of Food Insecurity

In the ensuing sections, we present a few of the most common measurements of food
security in the United States with their associated advantages and limitations to highlight
how difference in measurements may impact our understanding of food security.

2.5.1. US Household Food Security Survey Module and Food Insecurity Experience Scale
The US Household Food Security Survey Module (HFSSM) and Food Insecurity
Experience Scale (FIES) are two of the most used measures of food insecurity in the United
States. They are similar experience-based metrics that directly ask people about their access
to adequate food in a given reference period [68]. Both measures use yes-no questions to
Foods 2023, 12, 1816 9 of 21

determine individual’s level of food insecurity, starting with the least severe consequences
of food insecurity (worry about acquiring food) and progressively moving towards more
severe consequences (hunger). To illustrate, the first question of the FIES asks “In the
last year was there a time that you were worried you would not have enough food to eat
because of a lack of money or other resources?”, the third question asks, “In the last year
was there a time when you only ate a few kinds of foods because of a lack of money or other
resources?” the fifth question asks “In the last year was there a time when you ate less than
you thought you should because of a lack of money or other resources?”, and the eighth
and final question of the FIES asks, “In the last year was there a time when you went a
whole day without eating because of a lack of money or other resources?” [76]. The HFSSM
follows a very similar structure, but for households with children, it asks an additional
ten questions that specifically relate to children’s access to food [28]. Using data collected
by these measures, it is possible to estimate how many people in a given population are
experiencing food insecurity, as well as how extreme their experience with food insecurity
may be [68,77,78].
While similar in many ways, the HFSSM and the FIES do have some differences. Of the
two, the HFSSM (also known as the Core Food Security Module (CFSM)) was developed
first by the US Department of Agriculture through the Community Childhood Hunger
Identification Project in 1995 [49,68]. Since that time, the HFSSM has been widely used
to research the causes and consequences of food insecurity at the household level in the
United States and is administered today as part of the monthly Current Population Survey
(CPS) and the bi-annual National Health and Nutrition Examination (NHANES) [20,69].
As was mentioned, the HFSSM can be adapted for families with (18 questions) and without
children (8 questions). Its reference period can also be adapted, although typically it is used
to gather data about people’s experience with food insecurity in the past year or in the past
30 days [49]. It (along with a shortened 6-item version) has been validated in effectively
measuring people’s psychological experience with and economic access to food but falls
short in adequately capturing other dimensions of food access and other pillars of food
security [38,47,79]. The HFSSM is also lengthy and cannot be used to measure food security
on an individual level; therefore, it fails to provide an effective cross-national measure of
food insecurity.
The FIES was developed by the Food and Agriculture Organization (FAO) through
the Voices of the Hungry Project in 2014 [80]. Its similarity to the HFSSM can be attributed
to its basis in both the HFSSM and Latin America and Caribbean Food Security Scale
(ELCSA) [68]. In fact, the FIES was specifically developed to address some of the shortfalls
of the HFSSM. Accordingly, the FIES is a shorter, more standardized experience-based
measure of food insecurity that can be adapted to assess food insecurity at either the
individual or household level. Going one step further than the HFSSM, it can be used
to measure the percentage of individuals in the population who have experienced food
insecurity at moderate or severe levels during a given reference period [80,81]. Initially
administered in the Gallup Poll, the FIES has been recognized as a valuable global measure
and has been translated into 170 languages and dialects. It has been culturally attuned
and provides a standardized measurement of food security across countries despite vast
cultural and linguistic differences [76,80]. As the FIES has become increasingly accepted
worldwide, it has been used by the FAO (in conjunction with the PoU) to measure the
world’s progress toward its Sustainable Development Goals [68,80]. Notable strengths and
weaknesses of the FIES are listed below (see Table 4).
Foods 2023, 12, 1816 10 of 21

Table 4. Strengths and weaknesses of the FIES.

Strengths Weaknesses
Helps identify risk factors and consequences of food insecurity. Does not capture the full range of food security.
Can assist in identifying vulnerable populations before times of crisis. Does not measure diet quality, food consumption,
Effectively captures psychosocial aspects of food security. or expenditures.
Simple, time effective, and relatively inexpensive May be challenging for non-specialists to analyze data.
Provides a standardized and comparable global measurement. Assumes that the process of food insecurity is orderly and
Allows disaggregation of data by gender. predictable across all cultures.
Can be used in combination with other indicators. Is relatively new.
Has been effectively translated into many languages.
Note: Author’s compilation. Source: [68,72,80].

2.5.2. Household Food Insecurity Access Scale and Household Hunger Scale
Another common measure is the Household Food Insecurity Access Scale (HFIAS). The
HFIAS was developed by the United States Agency for International Development (USAID)
and is like the HFSSM and FEIS in that it is primarily used to measure a household’s access
to food [68,71]. It has a 30-day recall period and includes nine questions about psychological
and behavioral factors influencing food security at the household level [49,70]. These
questions ask about people’s feelings of uncertainty or anxiety related to food supply, as
well as the preferability, variety, and quantity of foods consumed at the household level [82].
While the HFIAS was initially developed for program monitoring and impact evaluation, it
has been used in other circumstances as well [49]. Critics of the HFIAS have pointed out
that the reports gathered through this method are subjective and not necessarily applicable
across cultures [5].
In response to these critiques, an improved version of the HFIAS, the Household
Hunger Scale (HHS), was recently developed. The HHS is very similar to the HFIAS, but
only has three questions that measure the most severe aspects of food insecurity [5]. As more
severe experiences of food insecurity are less subjective (e.g., running out of food is less
subjective than feeling anxious about running out of food), the HHS is believed to provide
more comparable results across countries and contexts [49]. Despite this improvement,
both the HFIAS and HHS have additional weaknesses, the most notable being that they
both fail to adequately measure other pillars of food security such as availability, utilization,
or stability.

2.5.3. Prevalence of Undernourishment

Food availability is often assessed using the Prevalence of Undernourishment (PoU)
indicator [49]. The PoU measure utilizes national food supply, consumption, and energy
needs data to estimate the percentage of a country’s population whose typical food intake
is below minimal consumption levels [5,68,72]. The FAO uses this indicator (in conjunction
with the FIES) to estimate the number of people who are likely not eating enough food
to meet their dietary energy needs at the national level [68,78]. This indicator is useful in
identifying countries in need and in making comparisons at the national level, but it does
not adequately identify vulnerable populations as it provides no specific data on what
households or individuals are food insecure or where those experiencing it live [5,29,68,78].

2.5.4. Coping Strategy Index

The Coping Strategy Index (CSI) was developed by the World Food Program and
the Cooperative for Assistance and Relief Everyone International (CARE International)
and is used to assess the frequency and severity of coping behaviors taken in response
to the experience of food insecurity [5,39,70]. It is used by a variety of organizations to
help identify at-risk and food insecure households [49,70]. No “universal CSI” exists as
every nation, region, and locality has different cultural norms and coping strategies that
are engaged in when responding to the experience of food insecurity [5,49]. Accordingly,
various culturally attuned versions of the CSI have been developed and are used in different
Foods 2023, 12, 1816 11 of 21

areas of the world [5]. For instance, in more developed nations, a Reduced Coping Strategy
Index (rCSI) is often used. This rCSI only measures a couple common, but less-severe
coping behaviors, in contrast to the CSI which includes measures of more severe coping
behaviors [70]. Because of the variations that exist between CSI measurement tools, it is
only to be used as a comparative indicator within a specified geographic area [5]. While
the CSI helps policymakers understand people’s behavioral responses to food insecurity in
a given region, it does not fully capture other important aspects of food security [49].

2.5.5. Household Dietary Diversity Score and Food Consumption Score

The Household Dietary Diversity Score (HDDS) and Food Consumption Score (FCS)
are used to assess food utilization. Both measures analyze the quantity and diversity of
foods consumed within a given reference period [70]. The HDDS was developed as part
of the Food and Nutrition Technical Assistance Project and assesses the number of food
groups that a household has consumed in the last 24 h [5]. It can be adapted to specifically
capture the experience of individuals (IDDS) or women (WDDS) and is predominately
used by the FAO and USAID [70]. Notably, the HDDS has no predetermined cut-off point
in establishing an adequate level of dietary diversity.
Like the HDDS, the FCS also assesses the number of food groups that a household
has consumed, but typically has a seven-day reference period. The FCS also measures the
quantity of foods consumed, applying weights to different food groups relative to their
nutritional value [70]. The FCS does have a predetermined cut off point in determining who
is or is not consuming adequate levels of dietary diversity, but these cutoffs are relatively
arbitrary [49]. The FCS is most often distributed by the World Food Programme [70]. While
extremely valuable, the FCS only captures dietary diversity on the household level and
does not account for differences in the intrahousehold consumption of nutrients [70].

3. Limitations
Measurement Limitations
Despite the progress that has been made in recent years in measuring food security, sig-
nificant limitations still exist in assessing these concepts. Most measures require significant
time, resources, and technological expertise to be understood and analyzed [68]. In addition
to the unavoidable complications accompanying any study involving human participants,
a researcher’s insufficient understanding of an indicator or combination of indicators may
result in a blindly inaccurate representation of food security. Even with a perfect under-
standing of indicators, however, measurement specific shortcomings complicate the process
of determining people’s food security status [5,83].
Many conventional efforts used to gather data using these indicators overlook the
experiences of ‘essential workers,’ homeless individuals, migrants, refugees, or others
living in marginal housing or on reserves [4,12,20,29,61,84]. This under coverage bias is
concerning as these groups are often more likely to report experiencing food insecurity [18].
The length of many food security measurements can also affect the representativeness
of samples. While answering the HFSSM’s 18 questions has been found to only take an
average of four minutes, being presented with such a lengthy questionnaire can still be
overwhelming [34]. Partially because of this, in times of recent crisis, the USDA has chosen
to rely upon a one-item food sufficiency question in the Household Pulse Survey (HPS) to
roughly estimate household’s access to food [28,85].

4. Conclusions
Although valiant efforts are underway to combat world hunger and reduce the number
of malnourished people, further progress will depend on clarifying the semantics of food
security and food insecurity. Despite the ratification of universal definitions in the 1990s,
which were meant to curb the development of new definitions, the terms have continued
to diverge due to the multifaceted nature of the concepts [86,87]. While most definitions of
food security/insecurity used today highlight similar points, slight, yet impactful, semantic
Foods 2023, 12, 1816 12 of 21

differences remain, hindering researchers, practitioners, and policymakers from effectively

measuring and finding solutions to food insecurity. By recognizing such semantic differ-
ences and the corresponding challenges of existing measurements of food insecurity, policy
makers and practitioners can create effective policies that will reverse the rising rates of
food insecurity the world is seeing today. Without re-emphasizing the use of consistent
definitions and measures of food insecurity, effective actions and policies to combat hunger
will remain beyond our reach.

Author Contributions: Conceptualization, R.M.S. and M.R.C.; methodology, R.M.S. and M.R.C.;
validation, M.R.C.; formal analysis, R.M.S.; investigation, R.M.S.; resources, M.R.C.; data curation,
R.M.S.; writing—original draft preparation, R.M.S.; writing—review and editing, H.M.J. and M.R.C.;
visualization, M.R.C.; supervision, M.R.C.; project administration, M.R.C. All authors have read and
agreed to the published version of the manuscript.
Funding: This research received no external funding.
Data Availability Statement: No new data were created or analyzed in this study. Data sharing is
not applicable to this article.
Conflicts of Interest: The authors declare no conflict of interest.

Appendix
The Tables A1 and A2 provide definitions of food security present in the literature since
1996 and 2000, respectively. The tables provide the citation, level of analysis (individual,
national, regional, etc.), and definition.
The Tables A3–A5 provide definitions and their citation of different ideas of ‘ade-
quate food’, ‘preferred foods’ and ‘culturally or socially acceptable means’ based on the
literature, respectively.

Table A1. Definitions of Food Security Used in the Literature Since 1996.

Citation Level of Analysis Definition

Bartfeld and Dunifon, 2006, p. 921 [60] Individual Assured access of all people to enough food for a healthy and
active life.
Béné, 2020 [88] Individual, Household When individuals and households have adequate resources to
obtain appropriate food
Blumberg et al., 1999, p. 1231 [79] Individual Assured access to nutritionally adequate and safe foods
without resorting to emergency food supplies, scavenging,
stealing, and other coping strategies.
Coleman-Jensen et al., 2021 [61] Individual Consistent, dependable access to enough food for active,
healthy living.
Committee on World Food Individual When all people at all times have physical, social, and
Security, 2012 [46] economic access to food, which is safe and consumed in
sufficient quantity and quality to meet their dietary needs and
food preferences, and is supported by an environment of
adequate sanitation, health services and care, allowing for a
healthy and active life.
Wood et al., 2000 [89] Individual The state in which all persons obtain a nutritionally adequate,
culturally acceptable diet at all times through local,
non-emergency sources.
FAO et al., 2009 [2] Individual Food security exists when all people, at all times, have physical,
social, and economic access to sufficient, safe, and nutritious
food that meets their dietary needs and food preferences for an
active and healthy life.
Hayes, 2021 [26] Individual Consistent access to enough food for active, healthy lives for all
household members at all times during the year.
Foods 2023, 12, 1816 13 of 21

Table A1. Cont.

Citation Level of Analysis Definition

Life Sciences Research Office and Individual Access by all members at all times to enough food for an active,
Andersen, 1990 [24] healthy life. Food security includes at a minimum:
the ready availability of nutritionally adequate and safe foods;
assured ability to acquire acceptable foods in socially
acceptable ways (i.e., without resorting to emergency food
supplies, scavenging, stealing, or other coping strategies).
Pinstrup-Andersen, 2009 [50] Global, National, Enough food is available, whether at the global, national,
Regional, Household community, or household level.
Pinstrup-Andersen, 2009 [50] Individual Access by all people to enough food to live a healthy and
productive life.
Prifti, 2021, p. 238 [72] National, Regional, A function of availability of adequate food in terms of quantity
Household, Individual and quality and the people’s ability to afford it at all times.
Siche, 2020 [90] Individual Everyone has unrestricted access to food that allows them to
satisfy their basic needs.
Sustainable Development Commission, National The aspiration for genuinely sustainable food systems, where
2009, p. 10 [91] the core goal is to feed everyone sustainably, equitably, and
healthily; which addresses needs for availability, affordability,
and accessibility; which is diverse, ecologically sound, and
resilient; and which builds the capabilities and skills necessary
for future generations.
Committee on World Food Individual When all people, at all times, have physical, social, and
Security, 2012 [46] economic access to sufficient, safe, and nutritious food that
meets their dietary needs and food preferences for an active
and healthy life . . . The four pillars of food security are
availability, access, utilization, and stability. The nutritional
dimension is integral to the concept of food security.
Winne et al., 2000, p. 4 [59] Regional All persons in a community have access to culturally
acceptable, nutritionally adequate food through local
non-emergency sources at all times.
World Food Program, 2009, p. 170 [67] Individual A condition that exists when all people, at all times, are free
from hunger.
World Food Summit, 1996 [2] Individual When all people, at all times, have physical and economic
access to sufficient, safe, and nutritious food that meets their
dietary needs and food preferences for an active and healthy
life.
Note: While not all-inclusive, the definitions presented illustrate the need for a comprehensive definition. To our
knowledge, all definitions are reported verbatim and are cited with their original source.

Table A2. Definitions of Food Insecurity Used in the Literature Since 2000.

Citation Level of Analysis Definition

Alaimo, 2005 [18] Global, National, Regional Limited or uncertain availability of nutritionally
adequate or safe foods.
Babu and Gajanan, 2021 [31] Individual A lack of access to the kinds and amounts of food
necessary for each member of a household to lead an
active and a healthy lifestyle.
Bergmans, 2019 [92] Individual The physical pain of hunger as well as the more
common experience of worrying about having enough
healthy food to eat.
Bovell et al., 2015 [93] Household Limited or uncertain access to enough food for all
household members to live active and healthy lives.
Coleman-Jensen et al., 2014 [94] Household A household-level economic and social condition of
limited or uncertain access to adequate food.
Coleman-Jensen et al., 2021 [61] Individual Access to adequate food is limited by a lack of money
and other resources.
Foods 2023, 12, 1816 14 of 21

Table A2. Cont.

Citation Level of Analysis Definition

Davitt et al., 2021 [95] Household Diminished variety, quality, and desirability of diet as
well as decreased access to food.
Donley and Gualtieri, 2015 [96] Individual Lacking enough money to buy the amount and variety
of food one needs or wants.
Dowler et al., 2001 [97] Individual The inability to acquire or consume an adequate quality
or sufficient quantity of food in socially acceptable ways,
or the uncertainty that one will be able to do so.
Economic Research Household Households were, at times, unable to acquire adequate
Service, 2022 [28] food for one or more household members because the
household had insufficient money and other resources
for food.
FAO et al. 2022 [3] Individual Lack regular access to enough safe and nutritious food
for normal growth and development and an active and
healthy life. This may be due to unavailability of food
and/or lack of resources to obtain food.
Food Forward, 2019 [98] Household, Lack of access to enough, good, healthy, and culturally
Individual appropriate food.
Frongillo and Horan, 2004, p. 28 [47] Global, Problems with the availability, accessibility, and
National, utilization of food.
Regional,
Household,
Individual
Gundersen and Ziliak, 2015, Household A condition which households lack access to adequate
p. 1830 [13] food because of limited money or other resources.
Harke et al., 2021, p. 1 [99] Household, Individual The lack of access to sufficient food because of limited
financial resources.
Life Sciences Research Office and National, Regional, Household The limited or uncertain availability of nutritionally
Andersen, 1990 [24] adequate and safe foods, or limited or uncertain ability
to acquire acceptable foods in socially acceptable ways.
Litton and Beavers, 2021 [100] Individual Reduced quality, variety, or desirability of diet.
Mardones et al., 2020 [101] Individual Unreliable physical, social, and economic access to
sources of adequate and nutritious food that meets
people’s dietary needs and food preferences.
Maxwell et al., 1990 [102] Individual The lack of access to enough food.
Miriam Webster Household, Individual The fact or an instance of being unable to consistently
Dictionary, 2022 [30] access or afford adequate food.
National Research Council et al., Household, Individuals and/or families in a household adjusting
2006 [8] Individual their dietary intakes or preferences because of a lack of
physical or economic resources.
National Research Council, 2006, p. Household, Uncertain, insufficient, or unacceptable availability,
4 [8] Individual access, or utilization of food.
National Research Council, 2006, p. Individual The social and economic problem of lack of food due to
44 [8] resource or other constraints, not voluntary fasting, or
dieting, or because of illness, or for other reasons.
Niles et al., 2020 [103] Household, Individual The lack of consistent physical, social, and economic
access to adequate and nutritious food that meets
dietary needs and food preferences.
Nord and Prell, 2007 [104] Household Household level economic and social condition of
limited access to food.
Foods 2023, 12, 1816 15 of 21

Table A2. Cont.

Citation Level of Analysis Definition

Nord et al., 2005 [105] Household, Individual The disruption of food intake or eating patterns because
of lack of money and other resources.
Power et al., 2016, p. 4 [106] Household, Individual Inadequate or insecure access to adequate food due to
financial constraints.
Roshanafshar and Hawkins, 2015, p. Household When one or more (household) members do(es) not
4 [107] have access to the variety or quantity of food that they
need due to lack of money.
Shapouri, 2010, p. v [108] Individual Consuming less than the nutritional target of 2100
calories per day per person.
United Health Foundation, 2022 Household Households unable to provide adequate food for one or
[17] more household members due to lack of resources.
US Department of Agriculture, 2022 Household Lack of available financial resources for food at the
[27] household level.
US Department of Agriculture, 2022 Household A household’s inability to provide enough food for each
[27] person to live an active healthy lifestyle.
Voices for Alabama’s Children, 2015 Household Lack of access, at times, to enough food for an active,
[109] healthy life for all household members and limited or
uncertain availability of nutritionally adequate foods.
Note: While not all-inclusive, the definitions presented illustrate the need for a comprehensive definition. To our
knowledge, all definitions are reported verbatim and are cited with their original source.

Table A3. Different Ideas of ‘Adequate Food’.

Citation Definition
Dietary Needs
Shapouri, 2010, p. v [108] Consuming less than the nutritional target of 2100 calories per day per person.
Nutritious (and Safe)
Alaimo, 2005 [18] Food insecurity: limited or uncertain availability of nutritionally adequate or
safe foods.
Life Sciences Research Office and Andersen, Food insecurity: whenever the availability of nutritionally adequate and safe
1990 [24] foods or the ability to acquire acceptable foods in socially acceptable ways is
limited or uncertain.
Blumberg et al., 1999, p. 1231 [79] Assured access to nutritionally adequate and safe foods without resorting to
emergency food supplies, scavenging, stealing, and other coping strategies.
Wood et al., 2000 [88] The state in which all persons obtain a nutritionally adequate, culturally
acceptable diet at all times through local, non-emergency sources.
Life Sciences Research Office and Andersen, Access by all members at all times to enough food for an active, healthy life.
1990 [24] Food security includes at a minimum: the ready availability of nutritionally
adequate and safe foods; assured ability to acquire acceptable foods in socially
acceptable ways (i.e., without resorting to emergency food supplies,
scavenging, stealing, or other coping strategies).
Quality
Prifti, 2021, p. 238 [72] A function of availability of adequate food in terms of quantity and quality
and the people’s ability to afford it at all times.
Foods 2023, 12, 1816 16 of 21

Table A3. Cont.

Citation Definition
Multifaceted
Winne et al., 2000, p. 4 [59] All persons in a community have access to culturally acceptable, nutritionally
adequate food through local non-emergency sources at all times.
Committee on World Food Security, 2012 [46] When all people at all times have physical, social, and economic access to
food, which is safe and consumed in sufficient quantity and quality to meet
their dietary needs and food preferences, and is supported by an environment of
adequate sanitation, health services and care, allowing for a healthy and
active life.
Davitt et al., 2021 [94] Food insecurity: diminished variety, quality, and desirability of diet as well as
decreased access to food.
Donley and Gualtieri, 2015 [95] Food insecurity: lacking enough money to buy the amount and variety of
food one needs or wants.
FAO, 2009 [2] Food security exists when all people, at all times, have physical, social, and
economic access to sufficient, safe, and nutritious food that meets their dietary
needs and food preferences for an active and healthy life.
Food Forward, 2019 [97] Food insecurity: lack of access to enough, good, healthy, and culturally
appropriate food.
Niles et al., 2020 [103] Food insecurity: the lack of consistent physical, social, and economic access
to adequate and nutritious food that meets dietary needs and food preferences.
World Food Summit, 1996 [2] When all people, at all times, have physical, social, and economic access to
sufficient, safe, and nutritious food that meets their dietary needs and food
preferences for an active and healthy life.

Table A4. Different Ideas of ‘Preferred Foods’.

Citation Definition
Tastes and Preferences
Mardones et al., 2020 [101] Food insecurity: unreliable physical, social, and economic access to sources of
adequate and nutritious food that meets people’s dietary needs and food preferences.
Niles et al., 2020 [103] The lack of consistent physical, social, and economic access to adequate and
nutritious food that meets dietary needs and food preferences.
Desirability
Davitt et al., 2021 [95] Food insecurity: diminished variety, quality, and desirability of diet as well as
decreased access to food
Donley and Gualtieri, 2015 [96] Food insecurity: lacking enough money to buy the amount and variety of food one
needs or wants.
Litton and Beavers, 2021 [100] Food insecurity: reduced quality, variety, or desirability of diet.
Culturally Acceptable
Winne et al., 2000, p. 4 [59] All persons in a community have access to culturally acceptable, nutritionally
adequate food through local non-emergency sources at all times.
Wood et al., 2000 [89] The state in which all persons obtain a nutritionally adequate, culturally acceptable
diet at all times through local, non-emergency sources.
Food Forward, 2019 [98] Food insecurity: lack of access to enough, good, healthy, and culturally
appropriate food.
Foods 2023, 12, 1816 17 of 21

Table A5. Different Ideas of ‘Culturally or Socially Acceptable Means’.

Citation Definition
Non-Emergency Means
Winne et al., 2000, p. 4 [59] All persons in a community have access to culturally acceptable,
nutritionally adequate food through local non-emergency sources at
all times.
Blumberg et al., 1999, p. 1231 [79] Assured access to nutritionally adequate and safe foods without
resorting to emergency food supplies, scavenging, stealing, and other
coping strategies.
Wood et al., 2000 [89] The state in which all persons obtain a nutritionally adequate,
culturally acceptable diet at all times through local,
non-emergency sources.
Life Sciences Research Office and Andersen, 1990 [24] Access by all members at all times to enough food for an active,
healthy life. Food security includes at a minimum:the ready
availability of nutritionally adequate and safe foods; assured ability
to acquire acceptable foods in socially acceptable ways (i.e., without
resorting to emergency food supplies, scavenging, stealing, or other coping
strategies).
Monetary Means
United Health Foundation, 2022 [17] Food insecurity: households unable to provide adequate food for one
or more household members due to lack of resources,
Coleman-Jensen et al., 2021 [61] Access to adequate food is limited by a lack of money and
other resources.
Donley and Gualtieri, 2015 [96] Food insecurity: lacking enough money to buy the amount and variety
of food one needs or wants.
Economic Research Service, 2022 [28] Food insecurity: household members were, at all times, unable to
acquire adequate food for one or more household members because
the household had insufficient money and other resources for food.
Harke et al., 2021, p. 1 [99] The lack of access to sufficient food because of limited
financial resources.
Gundersen and Ziliak, 2015, p. 1830 [13] Food insecurity: a condition which households lack access to
adequate food because of limited money or other resources.
Office of Disease Prevention and Health Promotion, Food insecurity: the disruption of food intake or eating patterns
2020 [110] because of lack of money and other resources.
USDA, 2021 [111] Food insecurity: lack of available financial resources for food at the
household level.

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