RESEARCH ARTICLE
A Model and Research Approach for Studying the
Management of Limited Food Resources by
Low Income Families
CATHY C. CAMPBELL AND ELLEN DESJARDINS
Department of Nutritional Sciences, University of Toronto, Toronto, Canada, M5S 1A8
ABSTRACT This small, intensive, inductive study was done
with 20 households, in order to generate the hypotheses and
methodological experience needed to pursue a larger deductive
hypothesis-testing survey on the nutritional needs and food
management strategies oflow income families with young chil-
dren. On the basis of this study, a model and a set ofhypotheses
about household food management strategies were proposed.
The model contains the major conceptual categories identified
in this study, as well as the dimension within each category
that appeared to be most important in understanding differ-
ences in household management strategies. The hypotheses
are proposed because of their potential to influence program-
ming for this target group. The methods developed are appro-
priate for research on the nature of food management strategies,
rather than research to assess the prevalence of food-related
stress. This study suggests that a thorough understanding of
the household context of food provisioning activities is essential
for both nutritionists and for the families themselves if there
is to be an improvement in the nutritional health oflow income
families and children. The results of this inductive study are
not generalizable but are intended to further program-relevant
research on this topic. IjNE 21:162-171, 1989)
INTRODUCTION
The increased demand for food assistance from soup
kitchens and food pantries in the 1980s has generated
wide-spread concern about the accessibility of food for
low income people. The research reported in this paper
grew out of a concern about food access problems and
out of a conviction that policies and programs designed
to address these problems need to be based on some
understanding' of the situations, priorities, and coping
strategies of low income families.
Research about food access problems and/or the im-
pact of income constraints on food consumption in de-
Please address correspondence to C.C. Campbell, Assistant Professor,
Division of Nutritional Sciences, Martha Van Rensselaer, Cornell Uni-
versity, Ithaca, NY 14853.
0022-3182/89/2104-0162$02.00/0
© 1989 SOCIETY FOR NUTRITION EDUCATION
162
veloped countries has been pursued in several different
ways. Some researchers with a predominantly social psy-
chological orientation have focused on the relative im-
portance of income-related factors in the food selection
process (1-3). Other researchers have used econometric
or more simple descriptive approaches to assess the rel-
ative importance of income in accounting for differences
in food expenditure, food purchases, and food and nu-
trients consumed (4--8). The Nationwide Food Con-
sumption Survey, the Continuing Survey of Food Intake
by Individuals, and the Health and Nutrition Exami-
nation Surveys have provided a rich data base for these
studies (9, 10). Other researchers have done community
surveys (11-15), descriptive studies of participants in food
assistance programs (16--24), or have organized public
hearings about food access problems (25, 26). However,
relatively few studies done in North America have used
a social anthropological orientation to understand the
actual actions taken by members of low income house-
holds to acquire, prepare and consume food (27-29),
although there has been increasing interest in this ap-
proach in research conducted in developing countries
(30, 31).
The initial conceptualization of the research reported
in this paper drew heavily on Whitehead's research (28),
the models reviewed by Piwoz and Viteri (30), aspects
of the food expenditure and intake survey methodologies
of the USDA's Continuing Survey of Food Intakes by
Individuals (10) and Statistics Canada's Family Food Ex-
penditure Survey (32), and an appreciation of the mo-
tivations behind (although not the methodologies of) the
community surveys and studies of the food assistance
program participants.
The objective of this project was to develop a model
and sampling and data collection protocols for a survey
to assess the nutritional needs of low income families
with young children, and to understand the strategies
such families use to manage their limited food resources.
Nutritional needs were evaluated in terms of food con-
J. ofNutr. Educ. Vol. 21, No.4
sumption patterns as a proxy for a more rigorous assess-
ment of nutritional status. Food coping strategies were
studied to identify, within the whole household context,
the practices that might be related to nutritional need.
Priority was given to the development of a model of
household food coping strategies, although attention was
also given to identifying the strengths and weaknesses
of an agency-based sampling protocol and various data
collection procedures. This project can be characterized
as a small, intensive, inductive study done to generate
the hypotheses and methodological experience needed
to pursue a larger, deductive, hypothesis-testing survey.
METHODS
The study used a mixture of qualitative and quanti-
tative approaches. Both semi-structured interviews (33)
and record-keeping procedures were used. The data col-
lection protocol developed over the course of the study
is summarized in Table 1 (34). The flow of topics was
from food-related practices to the more general family
situation, and within the food focus from the more gen-
eral to the more specific. The quantitative information
collected by the interviewer included food inventories,
children's food preferences and habits (food frequency),
the mother's food intake and sense of well-being (six non-
consecutive 24-hour food recalls), family income and ex-
penditures, and general demographic information. Each
household also kept food expenditure records for two
weeks. These diaries included records of eating outside
the home, meal companionship (commensality), and al-
ternate food sources (e.g. , gardens, gifts). All interviews
were conducted in the home at the convenience of the
participant, except for four food recalls which were done
by telephone. The female head of the household was the
principal respondent in each household, although in some
cases husbands or other adult friends also contributed
information. The face-to-face interviews were recorded
on tape and/or in notes taken by the interviewer. In
addition, the interviewer kept a journal of her obser-
vations, reflections and feelings about each interview.
The qualitative data contained in the interview tran-
scripts and/or notes and the interviewer's journal were
analyzed using Glaser and Strauss' constant comparative
method, supplemented by some of the techniques de-
scribed in detail by Spradley (35, 36). Although Sprad-
ley's focus on semantic relationships was not pursued,
his emphasis on the "use principle ... (which) states
that the meaning of a symbol can be discovered by asking
how it is used rather than asking what it means," the
focus on "events or a series of related events" as "or-
ganizing domains" in describing a cultural scene, and his
strategy to search for dimensions of contrast between the
domains studied were important premises underlying
the analysis (37). The basic categories of the proposed
August 1989 163
Table 1. Overview of Study Protocol
INTERVIEW 1:
Explanation of the Study
Family Composition
Family Food Patterns-daily food patterns; special meals;
recent changes in food patterns; frustrations and satis-
faction
Food storage-food supply inventory; food security
Introduction to Food Acquisition and Commensality Diary
TELEPHONE FOLLOW-UP-problem identification re rec-
ord-keeping
INTERVIEW 2:
Review Food Acquisition and Commensality Diary (week
1)
Food Acquisition - shopping patterns (e.g., stores, prac-
tices, transportation, mode of payment); eating out (e.g.,
sites, frequency, cost, changes); alternate food sources
(gifts given/received); frustrations experienced or changes
made.
Childrens' Food Patterns-child food frequency and fa-
vorite foods
Food Preparation-frequency of baking; trying new foods
and recipes; sources of food and nutrition information
Mother'S Food Intake Pattern-first 24-hour recall; weight,
height and age; general feelings over the day
TELEPHONE FOLLOW-UP-second and third 24-hour re-
call; problem identification re record-keeping
INTERVIEW 3:
Review Food Acquisition and Commensality Diary (week
2)
Family Finances-family income and expenditures;
Provisioning Strategies-transportation, childcare, clothing
and hair, laundry and diapers, toys, magazines and books,
furniture and appliances, health care, emergencies and
sources of support
Financial Decision-Making-priorities, frustrations and sat-
isfaction
Mother's Food Intake Pattern-fourth 24-hour recall
Family Characteristics-summary and review
Participant's Evaluation of the Study
TELEPHONE FOLLOW-UP-fifth and sixth 24-hour recalls
model of household food coping strategies were the prod-
uct of this analysis.
The quantitative data included the food expenditure
records, family financial information, the children's food
frequencies and the mother's 24-hour food recalls. The
household's food expenditures (in and outside of the home)
were summarized, taking into account the number of
meals those expenditures covered. The food frequency
information was summarized into the number of different
foods eaten daily, at least weekly, or rarely to never in
the following food groups: meat and alternates, milk
products, fruit , vegetables, high sugarlhigh salt foods,
and foods with a health connotation (e.g., yogurt, bean
sprouts, tofu, etc.). The 24-hour recall information was
analyzed both in terms of nutrient intake and food pat-
terns (e. g., the frequency of consumption of breakfast,
specific foods such as coffee, tea or soft drinks, and food
groups such as fruits, vegetables, dairy, etc.). Nutrient
164 Campbell & Desjardins I LOW INCOME FOOD MANAGEMENT
intake was determined using the Canadian national food
composition data base (38) accessed by CANDAT, a nu-
trient analysis software program (39). The adequacy of
nutrient intakes was determined relative to the Canadian
Recommended Nutrient Intake Standards, using the
probability approach outlined recently by the National
Academy of Sciences (40, 41).
The second stage of the analysis was a comparison
across the households in order to develop hypotheses
about the relationships between household characteris-
tics, different household coping strategies, and coping
outcomes defined in terms of the mother's nutrient in-
take and/or anxiety about the adequacy of food supplies
and/or income to purchase adequate food supplies. In
order to make this comparison across households, the
qualitative information had to be summarized into com-
mon categories or variables. These variables had not been
determined before the data were collected but were de-
fined on the basis of the qualitative analysis described
above. The categorization of the households on each var-
iable was done by the principal investigator, on the basis
of the interview transcripts and notes, and checked by
the interviewer, who had developed a more integrated
personal understanding of each household through the
interview process. Any differences in categorization led
to a reclarification of variable definition or a reassessment
of the meaningfulness of the distinctions being made.
The comparison across households occurred first in a
general fashion, with a juxtaposing of qualitative and
quantitative results. The quantitative information acted
as a check on some of the assumptions and/or groupings
developed with the qualitative information, and the qual-
itative analysis provided the contextual information with
which to understand the quantitative observations. Then
a more specific statistical assessment of relationships be-
tween variables was done. As the sample size was small
and the variables intercorrelated, this analysis was used
to explore the plausibility of a relationship. The results
were used only to reinforce or circumscribe interpreta-
tions developed more inductively. The products of this
stage of the analysis were the identification of dimensions
of contrast or differentiating characteristics between
households, the proposed relationships between the cat-
egories in the model, and a set of the hypotheses to
pursue in further research on this topic.
THE SAMPLE
The sampling goal for this study was a group of low
income families with at least one child under the age of
12 who were from as broad a range of different circum-
stances as possible in terms of family structure, size,
employment status, area of the city, etc. The sample was
drawn with the assistance of three agencies: the munic-
ipal social services department, and two community health
centers that served largely low income neighborhoods.
Although only 58% of the families contacted by the staff
of the agencies and/or the study staff agreed to partici-
pate, 87% of those who began actually completed the
rather demanding study in its entirety. This completion
rate and the extensiveness of the information shared in
this study was probably due to the time taken with the
participants, persistence in scheduling, the sequence style
and appropriateness of the interview questions, and the
open explanations given to participants about the study.
As the scale of this study precluded a representative
sample and therefore any claims to generalizability, this
response rate was not detrimental to the overall project.
It was more critical for the purposes of this study to have
a committed yet diverse sample.
The sample was 20 low income families living in To-
ronto, Canada (42). All the families had incomes less than
the minimum standard budget calculated that year by a
principal voluntary sector social welfare agency (43). There
were a total of 33 children, of whom 75% were less than
5 years old. Live-in husbands/fathers were present in
five families. One family was an extended family unit.
The range in family size was two to five members, with
30% being single parent families. One quarter of the
sample were black, West Indian households, 5% were
East Indian, and 70% were caucasian. The mothers were
19 to 38 years old (mean: 26 years) and 50% had com-
pleted high school. One quarter were employed (i. e.,
were the "working poor"); 75% received social assistance;
and 55% lived in subsidized housing (44). The sample
lived in four distinct areas of the city. The sample, there-
fore, represented a fairly diverse, though small, group
of low-income families.
RESULTS AND DISCUSSION
Three types of results were generated. One is a model
of household food management strategies in which both
the common and differentiating characteristics among
the households are identified. The model was developed
to guide the conceptualization and selection of variables
for further studies on this issue. The second type of
results is a set of hypotheses which appear plausible,
potentially informative, and feasible to pursue, but which
could not be definitively tested because of the small
sample size. Thirdly, a set of methodological observa-
tions were summarized to guide further research in this
area.
A. A Model of Household Food Management Strate-
gies. The model of household food management strat-
egies that was developed from this project is presented
in Figure 1. Conceptual rather than causal relationships
are indicated by interlocking boxes in the model, in order
to focus explicitly on the different contexts of food man-
J. ofNutr. Educ. Vol. 21 , No.4 Augusl1989 165

THE SYSTEM OR
WIDER ENVIRONMENT

HOUSEHOLD RESOURCE ENVIRONMENT

assets/liabilities:
1. INCO... 2. TDa I. IOCLU. .VPPORT NftWORX t. ROUIING I. BALTB

> scarce VI pleDtiful; chaotic. vs predictable

FAMILY PROVISIONING STRATEGIES

for
1. CJIIU) c.utB I . TJIAIIIIPORTATIOH S. C1.OTIUI t . LAUNJ)IlY" DlAPDI

> Home-made VI IDformally Bartered VI Markct EcoDomy

~. FOOD
I. fQQ~ A~QUISIIIQH; IHE SIQBE. BESIAUBAHI QB~IHEB

> cost ef ficieDcy

> cODsciously COD trolled vs uDcoDsciously spoDtaDcous

ii. SUnLl':. MAHAGEMEHD IHE III~HEH tUllQABR

> security vs iDsecurity

iii . lBElABAIIQH , ALLQ~AIJQHi IHE IAILE

> feediDI VI eatiDI
iv. tQHSUMlIIQH; IHElUU

> DutritioDal Quality

v . HEUIH' HUIBJIIQNU StAIUS

Figure 1: A Model of Household Food Management Strategies

agement approaches. The information collected about
the different dimensions of each conceptual category was
divided into that which was generally useful in under-
standing that category (the informative dimensions of a
category), and that which seemed most critical in char-
acterizing differences among households (the differen-
tiating dimension of a category). These differentiating
dimensions are also indicated in the model.
At the center of the model are the four categories and
locations (or phases and loci) (45) of household food man-
agement that had some experiential relevance to all the
participants: food acquisition - the store, restaurant or
other; supply management - the kitchen cupboard;
preparation and allocation - the table; and consumption
- the plate. Each of these four categories also emphasize
different dimensions of food: food as money, security,
enjoyment or chore, and nutriture. Each of these types
of food activity was studied in some detail and together
they comprise a description of a household's food pro-
visioning strategies.
The consumption category is the aspect of the house-
hold food activities that focuses on the individual and his
or her food selection and preferences. The informative
aspects of food consumption in this sample were the
variety offoods consumed; the frequency of consumption
of particular foods (e.g., dairy products; fruits; vegeta-
bles; and foods with strong health connotations - tofu,
bean sprouts, yogurt; high sugar foods; and different
drinks); the popular or most commonly consumed food
items; and, for the mothe rs, the number of meals they
ate. The key differentiating dimension among the house-
holds, however, was the nutrient adequacy of the moth-
ers' die ts: in particular her calorie intake and an average
of the probabilities of an inadequate nutrient intake of
protein, thiamin, riboflavin, niacin, Bs, folacin , vitamin
C, calcium, iron and zinc.
The preparation/allocation category is the social con-
text within which individual food consumption events
occur. The informative aspects of food preparation were
the time spent, the preference for homemade versus
store-bought items (baked goods, soups, stews, etc.), and
the frequency of innovation (in both food choice and
recipes). In general, however, food preparation was not
a significant source of interest or conversation with the
mothers (46). Food preparation issues were very tightly
linked to issues about food allocation. The most critical
dimension of contrast among the participants was the
degree of balance between a mother's activities to nur-
ture or feed others in her family and her own attention
to eating. Each of the mothers focused on feeding her
166 Campbell & Desjardins / LOW INCOME FOOD MANAGEMENT
children first; and for some, what was left over in terms
of food, energy or her own interest in eating, was not
enough. The mothers with the highest risk of inadequate
nutrient intake were those who ate the fewest calories
and concentrated on feeding their children (including
sitting down for meals with them), but not actually eating
themselves. Related issues of concern were isolation or
limited commensality (importantly lack of adult inter-
action), and the monotony or lack of enjoyment of the
food available.
Both the supply management and food acquisition cat-
egories represent the financial and material context within
which the social and individual activities occur. The
maintenance of adequate food supplies was a distinct
issue for the mothers, and represented the balance main-
tained between the household's food demands and its
formal and informal food acquisition activities. The in-
formative dimensions in supply management were time
since the last shopping, number of days' supply of food
available, staples on hand, and ownership of a freezer.
The key differentiating characteristic among the mothers
was the degree and frequency offood insecurity, worry,
or anxiety that she experienced.
Food acquisition was a multifaceted activity. Food was
acquired through multiple loci, including different types
of stores, restaurants and, very significantly, sources of
"free" or non-cost meals (daycares, neighbors and family,
charitable food assistance, etc.). In addition to the source
of food, issues of transportation, shopping frequency,
types of stores available, and options for food shortfalls
(47) were important. The households differed most sig-
nificantly interms of the cost efficiency of their acquisi-
tion (cost/capita and cost/meal), and the extent to which
they were both conscious or aware of and controlled in
their food expenditures (although premeditated or con-
sciously planned food selection (via shopping lists, etc.)
seemed less important). No simple or single most effi-
cient strategy of food acquisition can be described on the
basis of this study. Most households used multiple ap-
proaches to take maximum advantage of their resource
environments.
A household's food management strategies occur within
the context of the household's overall provisioning ac-
tivities. Besides food, the household also had to attend
to childcare, transportation, clothing, laundry and diaper
needs (48). Meeting the'se needs required planning,
priority setting, and considerable "juggling of nickels and
dimes." The households were differentiated on the basis
of three general provisioning approaches. Some families
were very self-reliant and focused on what they could
do on their own within their own home and limited
resources (i. e., they were not extensively involved in
social exchange networks nor with the formal market/
wage economy). Others relied on informal bartering of
services among often extensive networks of friends and
family. These households usually had no more than the
necessary contact with the formal market/wage economy.
The third approach was to rely primarily on formal in-
stitutions (banks, social service system) for resources and/
or to work hard to enter the market/wage economy (via
further education, intensive job searches). These house-
holds purchased rather than bartered services. Each of
these general provisioning approaches had both strengths
and significant weaknesses.
The household's provisioning efforts occurred within
its general resource environment or context. Money from
all different sources (formal and informal) was certainly
a critical resource, but was not the only significant char-
acteristic (either as an asset or liability) of a household's
resource environment. The unstructured time available
to household members, the health status of members,
the housing situation (as a direct cost but also, to a lesser
extent, the quality of housing), and, importantly, the
social, support network of the household (both from the
formal and informal sector) (49) were key differentiating
characteristics of the households' resource environments
(50). Various combinations of these latter resources could
offset, to some extent, differences in income (given the
limited range considered in this study). Although a dif-
ferentiating characteristic of household resource envi-
ronments was its scarcity or richness, also critical was
the predictability of resource availability. The unpre-
dictability of some working families' incomes was a dis-
tinct liability, in comparison with the predictability of
social assistance income. With no formal savings or in-
surance, the predictability of family income was a par-
ticularly critical issue. The different dimensions of a
household's resource environment were not completely
inter-changeable and therefore could not be reduced to
a simple economic characterization.
The narrowest conceptual category in Figure 1 (health
and nutritional status) and the widest (the system or
wider environment) were not studied in detail, but were
included in order to define the boundaries of the model
or the logical directions in which the model could be
extended. The few dimensions of these categories that
were considered were each important differentiating
characteristics. For the health and nutritional status cat-
egory, maternal weight status and general well-being (51)
were studied; and for the wider environment, the gro-
cery shopping environment was considered. These are
not included in the model because no attempt was made
to explore the categories in detail.
Given the complexity of anyone of these conceptual
categories, it is not surprising that the interrelationships
between the categories were not simple. In general, it
was much easier to delineate relationships between any
of the adjacent categories, than between those removed
by one or more levels. For instance, some relationships
were observed between weight status or preparation/
allocation variables and food or nutrient intake patterns,
but not between food acquisition and food or nutrient
J. ofNutr. Educ. Vol. 21, No.4
intake patterns. In order to delineate relationships be-
tween nonadjacent categories, all the different activities
that occur in the intermediary category need to be taken
into account. For instance, in order to identify the re-
lationships between a family's resource environment and
its food acquisition activities, the family's general pro-
visioning strategies need to be taken into consideration;
or in order to understand how a family's food acquisition
activities affect food consumption patterns, differences
in food supply management and preparation/allocation
patterns need to be defined. Certainly a significantly
larger sample and probably a longitudinal design would
be necessary to characterize the relationships in a causal
rather than a conceptual manner.
B. Potentially Plausible Hypotheses. On the basis of
this project, six hypotheses are proposed for further test-
ing on a broader-based representative sample. Although
not all of the hypotheses are new, observations on this
small sample support their importance. The hypotheses
also challenge common assumptions about appropriate
programming approaches for families with limited in-
come. The first four hypotheses emerge directly from
the data, while hypotheses 5 and 6 relate to the broader
conceptualization of the issue. The results of this study
support each of these hypotheses, but do not confirm or
disprove them.
The first hypothesis is: the risk of inadequate nutrient
intake is more related to total calorie intake than to the
specific foods selected. This hypothesis is based on the
observation that, although many of the mothers had lim-
ited intakes of dairy products and vegetables, the moth-
ers with the worst food intake patterns in this sample
simply ate very little. The constraints (psychological,
physical and economic) on their food consumption were
overwhelming for some mothers. In addition, remarka-
bly few nutritionally frivolous foods were noted in the
food inventories, food expenditure records, or food in-
take records of most of the families. If hypothesis 1 is
true, significant programming attention needs to be di-
rected toward the context of food consumption, in ad-
dition to the more common focus on food selection per
se.
The second hypothesis is: mothers' diets deteriorate
before their children's. This hypothesis is based on the
observations that (a) the mothers' diet seemed worse than
their children's-(52); (b) the children seemed to be given
priority when food was limited; and (c) mothers would
feed their children but not themselves. If hypothesis 2
proves true, then significant attention needs to be given
to mothers' food and health needs, in addition to the
more common focus on children's food and health needs.
Also, the quality of mothers' diets may be an early warn-
ing indicator for compromised food intake on the part of
their children, and poor child nutrition could indicate
inadequate maternal nutriture.
August 1989 167
The third hypothesis is: the cost efficiency of food
acquisition is more related to the conscious attention paid
to food financing than to food selection per se . It is based
on the observation that the cost per person or per meal
spent over the two week expenditure recording period
was more strongly related to the mother's general aware-
ness of and control over her food expenditures than her
self-reported pre-planning of food purchases. All the
mothers were consciously struggling with their financial
constraints. Some mothers, however, kept a more careful
mental account of the dollars they spent on food both in
and outside of the home than others. For some, the food
expenditure records were the first time they were ac-
tually aware of their total food expenditures and where
their food dollars were being spent. If hypothesis 3 is
true, programming attention needs to be paid to devel-
oping participants' awareness of their own dollar ex-
penditures, in addition to the more common focus on
food selection and purchasing skills.
The fourth hypothesis is: families are more at risk when
they are entering or attempting to leave poverty. It is
based on the observation that, although most households
were experiencing considerable crisis and change (53),
many had developed a system or routine for managing.
This system took time to develop. Those whose contexts
had changed drastically as they were either entering or
attempting to leave poverty were very vulnerable, dur-
ing the period when they were learning to adapt their
routines to these new circumstances. If hypothesis 4 is
true, concerted attention needs to be focused on people
in transition, in addition to the more easily identifiable
and programmatically accessible households who have
been in their current situation for some time.
The fifth hypothesis is: socio-economic differences are
not reflected in differences in basic household food man-
agement strategies but in the trade-offs of a strategy, the
differing emphases among the strategies, and the impli-
cations of misjudgment. This hypothesis is based on the
observation that there was nothing unusual, extreme or
distinctive about the types offood management strategies
used by these families. What was notable for these fam-
ilies, however, was the absence of much room for error,
frivolity or, in some cases, simple choice. If hypothesis
5 is true, then more programmatic attention needs to be
directed to the context of, pressures on, and adaptability
of food management strategies, in addition to the more
common focus on the strategies themselves.
Finally, hypothesis 6 is: participatory research has
significant potential as an educational and community
organizing approach. It is based on the unintentional
educational value of the research project for the partic-
ipants. Although this phenomenon has often been con-
sidered a problematic outcome to intensive research
projects, this study suggests that it might be possible to
use research participation intentionally to meet educa-
tional objectives. In the evaluation of their experience
168 Campbell & Desjardins / LOW INCOME FOOD MANAGEMENT
with the research process, most participants noted an
increased awareness of their finances and diet; some were
interested in the other participants' strategies; and some
were anxious that "the government" would learn about
their situation. No advice or information was given to
the study participants. They were simply encouraged to
reflect and talk about their food-related practices in a
very detailed fashion . In addition, many participants had
very limited contact with the formal social services sys-
tem. If this experience is generalizable, research projects
structured to ensure maximum involvement of the par-
ticipants may be an innovative way to educate a hard-
to-reach audience, and a more effective way to stimulate
community action by the participants than more tradi-
tional didactic educational approaches.
C. Methodological Observations. The in-depth infor-
mation collected through multiple contacts with the same
households, using quantitative record-keeping proce-
dures, telephone follow-ups, and structured but open-
ended questioning was both a feasible and essential in-
gredient for understanding family food practices. The
quantitative information stimulated a lot of discussion;
in some cases, it made the participant self-conscious of
her tacit knowledge and practices; and, in most cases, it
made the generalized and/or idealized descriptions of
family practices that emerged from the interview dis-
cussions much more concrete and specific. However,
scheduling multiple interviews with families, many of
whom were very stressed, required considerable flexi-
bility and persistence.
This study used different agencies to identify the study
sample, in order to maximize the differences in family
circumstances in the sample. Interestingly, the use of
different agencies increased the range of household in-
come sources (different social assistance programs and
wages), and also ensured geographical distribution in the
city, which was important because of the influence that
the different shopping environments had on family food
provisioning strategies. The use of different agencies was
also important in terms of understanding social networks:
the participants from the community health centers were
more connected to community agencies than some of
those contacted through the municipal social services
department. Because charitable food assistance programs
(food pantries or banks) were not used to identify the
study sample,.as has often been done in hunger studies,
it was possible to obtain some indication of the proportion
of households experiencing food stress who were actually
using these food assistance programs: 15%. One of the
problems with an agency-based sampling strategy, how-
ever, is establishing a systematic procedure for identi-
fying participants while ensuring both confidentiality for
participants and minimal time commitment for agency
staff. This project was only partially successful in this
regard.
Four types of quantitative records of food-related phe-
nomena were collected in this project. This combination
provided ample opportunity for cross-checking infor-
mation. Of these records, the food expenditure infor-
mation was the most difficult to collect. Although it was
possible to obtain records of dollars spent, only 55% kept
accurate, detailed records of the actual foods purchased,
25% had some difficulties, and 20% had major problems
even with considerable prompting. As a result, infor-
mation about the specific foods purchased was not ana-
lyzed. In order to interpret the household's expenditure
on food for home consumption, it was critical to have (a)
a record of the number of meals for which that food was
purchased (i. e., the meals eaten at home by household
members and visitors); and (b) alternate sources of food
(40% of the households received free food over the two
week record time).
Collecting multiple 24-hour recalls from the mothers
was not a problem and allowed for analysis based on an
estimate of each woman's usual intake pattern. A record
of the mother's general feeling at each eating event pro-
vided information about the positive or negative context
of the event. In contrast with the accuracy possible in
the assessment of the mothers' food intake, the food
frequency information for the children did not allow a
very extensive evaluation of their diets. Collecting more
detailed information was problematic because the moth-
ers were not familiar with their children's food intake
outside of the home. The food frequencies did, however,
provide general descriptive information about the range
of foods in each child's diet.
On the basis of this study, two observations can be
made about studying involuntary food shortages or what
is colloquially being referred to as "hunger." First, al-
though most households in this study were not currently
experiencing an acute food shortage and, in fact, very
few had used a charitable food assistance program, many
of them were under considerable stress in acquiring and
managing their food supplies (i. e., experiencing food
stress). A person who is not currently short of food may
still be experiencing Significant food stress, and the num-
ber of people using charitable food assistance programs
is not an accurate indication of the total number of people
actually experiencing food stress in a community. Sec-
ondly, observations in this study suggest that worry about
the adequacy of the household's food supplies, parents
skipping meals, and parents eating differently than their
children may be useful indicators of food stress.
CONCLUSION
Managing limited food resources was a task accomplished
with varying degrees of success by all the families in this
study. Many of the commonly noted issues for low in-
come families, such as difficulty with transportation, the
J. ofNutr. Educ. Vol. 21, No.4
importance of freezers, the micro-strategies for rationing
food within the family, and stretching staples were also
noted by these families. With a few exceptions, the fam-
ilies in this study were very frugal and had an appreci-
ation of the importance of nutrition for the health of their
children. The differentiating characteristics among these
families included: differences in the richness and pre-
dictability of their resource environments, the degree to
which the families relied on the formal wage economy
and/or informal bartering network to ensure adequate
household provisioning, the extent to which the mothers
were self-aware (54) and consciously exerted some con-
trol over family food provisioning activities, the degree
of security about the adequacy of food supplies that was
experienced, and the extent to which the mother cared
for herself as well as her children and managed to achieve
an adequate diet. An appreciation of all of these issues
needs to be systematically incorporated into nutrition
interventions targeted for this group. This study would
suggest that a detailed appreciation of the household
context is essential for both the nutritionist and the fam-
ilies themselves for an improvement in the nutritional
health of low income families and children.
This study was originally proposed as a methods de-
velopment project for a larger survey which would have
two purposes: to assess nutritional needs and to under-
stand household food management strategies. In at-
tempting to define variables critical to the second pur-
pose, the methods development for assessment was short-
changed. It appears, in retrospect, to be rather naive to
expect both to understand the complexity of the intra-
household context of family foodways and to assess the
magnitude of food needs on a large sample. Because both
purposes are valid and necessary, some compromise must
be identified. The best trade-off of large-scale but de-
scriptively thin surveys to small-scale but descriptively
thick studies (55) might not be medium-scaled studies of
several hundred participants, but rather concurrent small-
scale and large-scale projects. Complementary concur-
rent projects might avoid arguments about the priority
of either approach and might allow for a more complete
utilization of each methodology. Certainly the conceptual
clarification and appreciation of the context of a phenom-
enon that is possible with small in-depth studies needs
to go hand in hand with studies of the causes, prevalance
and generalizability of a phenomenon.
ACKNOWLEDGMENTS
The authors could like to thank the Community Services De-
partment of Metropolitan Toronto, the Riverdale Community
Health Center and the Parkdale Community Center for their
cooperation, and the Ontario Ministry of Health for funding of
this research.
August 1989 169
NOTES AND REFERENCES
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trition 35:1310--18, 1982.
3 McKenzie, J. The impact of economic and social status on food
choice. Proceedings of the Nutrition Society 33:67-73, 1974.
4 Davis C.C. Linkages between socioeconomic characteristics, food
expenditure patterns, and nutritional status of low income house-
holds : Acritical review. AmericanJournal of Agricultural Econom-
ics 64:1017-25, 1982.
5 Morgan, K.J. Socioeconomic factors affecting dietary status: An
appraisal. American Journal of Agricultural Economics 68:1240--
46, 1986.
6 Windham, C .T. , B.W. Wyse, R.C. Hansen, and R.L. Hurst. Nu-
trient density of diets in the USDA nationwide food consumption
survey, 1977-78: 1. Impact of socioeconomic status on dietary den-
sity. Journal of American Dietetic Association 82:28-34, 1983.
7 U .S. D. A. Science and Education Administration, Nationwide Food
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of low-income households, November 1977-March 1978. Prelimi-
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8 McKenzie, J. Economic influences on food choice. In Nutrition
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tion, 1980, pp. 91-103.
9 U.S . Department of Health and Human Services and U.S. De-
partment of Agriculture. Nutrition monitoring in the United States
- A report from the Joint Nutrition Monitoring Evaluation Com-
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10 Human Nutrition Information Service. Nationwide food consump-
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port #85-1. United States Department of Agriculture, 1985.
11 Dandoy, S., P.C. vanDyck, and S. Ernst. Utah nutrition monitor-
ing project: Study of the low income households. Salt Lake City,
Utah: Utahs Against Hunger and Utah Department of Health, May
1986.
12 Scott, R. Arkansas hunger project. Conway, AR: University of
Central Arkansas, undated.
13 Wehler, C.A. Community childhood hunger identification project.
Hartford, Connecticut: Connecticut Association for Human Serv-
ices, 1987.
14 Zogby, J. Stmctures of misery: Hunger in our communities . Utica,
New York: The John Zogby Croup, 1988.
15 Withers, l.A. Hunger in Dade county, Florida. Miami, Florida:
Metro-Dade Community Action Agency, 1985.
16 Lamphere, J-A. , J. Jones, and V.W. Sidel. Hunger watch New
York S tate part 1: Profile of at-risk populations and service agen-
cies. New York City, NY: Montefiore Medical Center, February
1984.
17 Abelow, B., P.A. Rode, C. Kumekawa, and S. Belton . Homegrown
hunger - A study of people who use emergency food shelves in
Minnesota. Minneapolis, MN: Minnesota Food Education and Re-
source Center, Urban Coalition of Minneapolis, December 1985.
18 Laven, C. T. and K. C. Brown. Nutritional status of men attending
a soup kitchen: A pilot study. American Journal of Public Health
75:87&-878, 1985.
19 Sreenivasan, L. Sacramento county hunger survey. Sacramento,
CA: Cooperative Agricultural Extension, University of California,
June 1985.
20 Northern California Anti-Hunger Coalition. Hunger surgey: A sur-
vey of recipients of emergency food assistance in San Francisco,
Alameda, and Santa Cruz counties. Sacramento, CA: California
Rural Legal Assistance Foundation, December 1984.
21 Levens, B.R. and M. Clague. Food bank users: A profile of the
hungry in B.C. Vancouver, Canada: Social Planning and Research
Council of B.C., June 1986.
22 Edmonton Cleaners Association. Hunger in our city: A question of
responsibility. Edmonton, Canada: February 1985, unpublished
report.
23 De partment of Social Services. Calgary/Edmonton surgey of food
ban users. Edmonton/Calgary: Canada, May 1986, unpublished
report.
 170 Campbell & Desjardins / LOW INCOME FOOD MANAGEMENT
24 10 Days for World Development Committee. Poverty - The only
thing 11UJney can't buy. St. John's, Newfoundland: The United Church
Council of Social Ministries, March 1987.
25 Physician Task Force on Hunger in America. Hunger in America:
The growing epidemic. Cambridge, MA: Harvard University, 1985.
26 President's Task Force on Food Assistance. Report of the Presi-
dent's Task Force on Food Assistance. Washington, D.C., 1984,
unpublished report.
27 Sanjur, D., P. Haines, S. Travis, M. Brooks, B. Hammons, and
M.D.C. Immink. Food expenditures, consumption, and nutrient
availability among New York State EFNEP households. Cornell
University, College of Human Ecology. Search 9:1-58, 1979.
28 Whitehead, T. L. Sociocultural dynamics and food habits in a south-
ern community. In Food and the social order: Studies in food and
festivities in three American communities, M. Douglas, ed. New
York: Russell Sage Foundation, 1984.
29 Emmons, L. Food procurement and the nutritional adequacy of
diets in low-income families. Journal of the American Dietetic As-
sociation 86:1684--93.
30 Piwoz, E.G. and F.E. Viteri. Studying health and nutrition be-
haviour by examining household decision-making, intra-household
resource distribution, and the role of women in these processes.
Food and Nutrition Bulletin 7:1-31, 1985.
31 Messer, E. The household focus in nutritional anthropology: An
overview. Food and Nutrition Bulletin 5:2-12, December 1983.
32 Statistics Canada, Family food expenditure in Canada, 1982. Min-
ister of Supply and Services Canada. Catalogue 62-554, Ottawa,
1984.
33 A semi-structured interview has a clearlv defined se, 'If issues about
which the interviewer will question the respondent, but the re-
spondent is encouraged to address the issue in any way or order
that is most appropriate for her (or him). Both open-ended and
follow-up probe questions are used. No pre-formulated response
categories are defined. All the interviews cover the same core set
of issues, but also include whatever additional topics the respondent
volunteers.
34 A complete copy of the final data collection protocol, as well as a
detailed description of the data actually collected, is available from
the first author.
35 Glaser, B.G. and A.L. Strauss. The discovery of grounded theory:
Strategies for qualitative research. New York: Aldine DeGruyter,
1967.
36 Spradley, J.P. The ethnographic interview. New York: Holt,
Rinehart and Winston, 1979.
37 ibid. pp. 156, 197, and 196.
38 The United States Department of Agriculture's Handbook #8 data
is modified by Health and Welfare Canada to take into account
differences in food ingredients and fortification regulations between
the two countries.
39 CANDAT, a nutrient calculation and reporting system. London/
Ontario: Iota Computer Services Limited, 1984.
40 Subcommittee on Criteria for Dietary Evaluation, Food and Nu-
trition Board, Nutrient adequacy: Assessment usingfood consump-
tion surveys. Washington, DC: National Academy Press, 1985.
41 Appendix D (40) includes an overview of the computer program
developed by G. Beaton, University of Toronto, which was used
to determine the probability of inadequate nutrient intake.
42 The greater Toronto area is one of the largest and most prosperous
urban centers in Canada.
43 Guides for family budgeting. Toronto: Social Planning Council of
Metropolitan Toronto, 1985.
44 No government food assistance programs analogous to the food
stamp, surplwf commodity foods, school breakfast or school lunch
programs in the United States exist in Ontario. The Healthiest
Babies Possible program provides in-home education and milk
vouchers to pregnant low-income mothers in Toronto, but only
20% of the sample had participated in this program. The vast ma-
jority of social assistance is provided as a cash grant once a month.
45 Goody, J. Cooking, cuisine and class. New York: Cambridge Uni-
versity Press, 1982, pp. 37.
46 This might account for the absence of concern with cooking facilities
even though some were quite limited.
47 Credit at food stores was not used and/or was not an option available
for these households.
48 Housing was placed in the household resource environment rather
than in the provisioning strategy category, because shelter was a
substantial expenditure made only once a month about which rel-
atively few decisions were made with any frequency.
49 There is an extensive literature on social support - its different
dimensions and its measurement (see Sarason, Irwin G. and Barbara
R. Sarason, eds. Social support: Theory, research and applications.
The Hague, The Netherland: Martinus Nijhoff Publishers, 1985;
Gottlieb, B.H., ed. Social networks and social support. Volume 4,
Sage Studies in Community Mental Health. Beverly Hills: Sage
Publications, 1981; Cohen, Sheldon and S. Leonard Syme. Social
support and health. New York: Academic Press, Inc., 1985). In
this study, a household's formal and informal social support network
was considered a resource, not only as a source of economic aid
but also as a source of social and psychological benefits and liabil-
ities. For the interhousehold comparisons, a simple count of the
number of family and friends in the network and the number of
health and social welfare agencies utilized were considered.
50 Education per se was not a critical differentiating resource among
this group of households, even though they did vary in formal
educational attainment.
51 Maternal weight status was self-reported. The mood or general
feeling at each of the mother's eating events over the six days of
her food intake records was noted. In addition to tiredness, the
other negative feelings were all health-related and provided an
indirect indication of maternal well-being.
52 This could not be tested even on this small sample because only
food frequency information was collected on the childrens' food
intake patterns.
53 Eighty-five percent of the sample had experienced at least one of
the following events in the past 12 months: husband leaving (5),
birth of a baby (8), employment terminated (10), employment found
(7 - 4 during the study), return to school (6 - 1 during the study),
eviction or notice of (3 - 1 during the study), change of residence
(4), started social assistance (9), illness (4 during the study). The
numbers in parentheses are the number of families who had ex-
perienced that event.
54 Self-awareness is not synonymous with knowledge about nutrition,
food budgeting, preparation, etc. It is rather specific knowledge
about the household's provisioner(s) own behavior in each of the
dimensions of food-related practice.
55 Geertz, C. Thick description: Toward an interpretive theory of
culture. In The interpretation of cultures. New York: Basic Books,
Incorporated, 1973.
RESUME Cette modeste et intensive etude inductrice a
ete menee aupres de 20 families dans Ie but de generer les
hypotheses et la me thodologie necessaires ala poursuite d'une
enquete de plus grande envergure de type deductrice qui ser-
vira a tester des hypotheses sur les besoins nutritionnels et les
strategies d' acquisition alimentaire des familIes a faible revenu
ayant de jeunes enfants. Sur la base de cette etude, un modele
et une serie d'hypotheses sur les strategies d' acqUisition ali-
mentaire de la familIe sont proposes. Le modele contient les
principales categories conceptuelles identifiees dans cette etude
ainsi que la dimension a l'interieur de chaque categorie qui
apparait la plus importante pour la comprehension des differ-
ences dans les strategies d'acquisition alimentaire des familIes.
Les hypotheses sont proposees a cause de leur potentiel a
influencer la planification de programmes diriges vers ce groupe
cible. Les methodes developpees conviennent a une recherche
sur la nature des strategies d' acqUisition alimentaire plutot qu'a
une recherche qui aurait pour but d' evaleur la prevalence du
stress alimentaire. Cette etude suggere qu'une evaluation de-
taillee du contexte familial est essentielle autant pour les nu-
tritionnistes que pour les familIes elles-memes s'il doit y avoir
une amelioration de la sante nutritionnelle des familIes a faible
J. ofNutr. Educ. Vol. 21, No.4 August 1989 171

revenu et de celie de leurs enfants. Les resultats de cette etude
inductrice ne peuvent etre generalises mais i1s ont pour but
de faire avancer la recherche de type "programme" dans ce
domaine. aNE 21:162-171, 1989)
Translated by Agathe Pellerin
RESUMEN Este pequeiio estudio intensivo e inductivo,
fue realizado en 20 hogares para generar las hipotesis y ex-
periencia metodologica necesarias para iniciar una encuesta
mas amplia, deductiva, de prueba de hipotesis, sobre las ne-
cesidades nutricionales y estrategias de administracion de ali-
mentos de familias de bajos ingresos con ninos pequeiios. Sobre
la base de este estudio, se propuso un modelo y un conjunto
de hipotesis sobre estrategias de administracion de alimentos
en el hogar. El modelo contiene las principales categorias con-
ceptuales identificadas en este estudio, asf como la dimension,
dentro de cada categorfa, que resulto mas importante para
entender diferencias en las estrategias de administracion de
alimentos a nivel de los hogares. Las hipotesis se proponen por
su potencial para influir en la planificacion de program as para
este grupo objetivo. Los metodos desarrollados son mas apro-
piados para investigar la naturaleza de las estrategias de ad-
ministracion de alimentos que para evaluar la prevalencia de
periodos de carencia de alimentos. Este estudio sugiere que
una apreciacion detallada del contexto del hogar es esencial
tanto para los nutricionistas como para las propias familias, si
se pretende mejorar la salud y nutricion de familias y niiios de
bajos ingresos. Los resultados de este estudio inductivo no
pueden generalizarse pero se pre ten de que promuevan mayor
investigacion en este topico, relevante para programas.
aNE 21:162-171, 1989)
Translated by Ligia Rodriguez

EFFECTS OF DIETS CONTAINING HIGH AMYLOSE VS AMYLOPECTIN

STARCH ON METABOLIC FACTORS IN HUMAN SUBJECTS

Behall et al . investigated the influence of a diet containing 34% of calories as 70% amylose
(a straight chain molecule) or 70% amylopectin (a branched chain molecule) starch on the
metabolic factors associated with abnormal states. They also reported on the glucose and
insulin responses following long term feeding of amylose or amylopectin rich starch (American
Journal of Clinical Nutrition 49:337-344, 1989). The subjects for the study were twelve men
volunteers averaging 34 years in age and 77.3 kg in body weight; all twelve were within 20%
of their desirable height/weight ratio. None of the subjects was taking any drugs known to
affect glucose or insulin metabolism. A basal diet with a 4-day rotating menu was fed throughout
the 10-week study. The diet provided about 11.2%, 36.7%, and 52.1 % calories from protein,
fat, and carbohydrate, respectively. Sixty-six percent of the carbohydrate calories fed were
from cornstarch, comprised of either 70% amylose or 70% amylopectin. Each diet starch was
fed to the subjects for 5 weeks in a crossover design. Caloric intake ranging from 2500 to 3400
kcalJday was adjusted to maintain the subjects' body weight throughout the study.
A standard glucose tolerance test was given before the controlled feeding began and after
4 weeks on either the high amylose or the high amylopectin diet (fourth and ninth week of
the study). The corresponding dietary starch challenge was given as a cracker (lg starch +
0.3g fat/kg body weight) at the end of each feeding period (the fifth and tenth week). Blood
was drawn before and 0.5, 1, 2, 3 and 4 hours after the glucose load or starch challenge meal
was ingested. Blood was analysed for glucose, insulin, glucagon, triglycerides, cholesterol,
high density lipoprotein (HDL), blood urea nitrogen and uric acid.
The researchers observed that responses of plasma glucose, insulin and glucagon to a glucose
tolerance challenge given after four weeks on either an amylose-rich or an amylopectin-rich
diet were not Significantly different. However, when a starch challenge test corresponding to
the starch in the diet being fed, was administered after the fifth diet week, plasma glucose,
insulin and glucagon response curves varied by starch type.
The authors conclude that the use of amylose in the diet may be of benefit to those individuals
who are intolerant to a standard carbohydrate diet as well as those who are diabetic or obese
and insulin resistant. However, a previously observed decrease in glucose and insulin response
after feeding high carbohydrate diets based on unpurified starch cannot be attributed only to
higher amylose levels, as those diets would also have been high in other factors such as fiber
content which have been reported to affect glycemic response. (43 references)
Summarized by Madansinh Vaghela