Nutrition and Food Security among Veterans: Operationalizing ‘Nutritional Functioning’

Objective To assess injured military veterans’ experiences, beliefs and daily physical and psychosocial functioning in relation to food and nutrition. Design We used a convergent mixed-methods study design, and the International Classification of Functioning, Disability and Health to operationalize the core constructs and influencing factors related to physical and psychosocial functioning, and food and nutrition. Setting Three Veterans Affairs Polytrauma Rehabilitation Centers. Participants Veterans who served in the United States military on or after September 11th, 2001, and whose medical diagnoses met the criteria for polytrauma; at least one mild traumatic brain injury, and at least one associated comorbidity (e.g., post-traumatic stress disorder, chronic musculoskeletal pain, vestibular disturbances). Intervention None Main Outcome Measures Themes from survey responses and semi-structured interview data were pooled into core constructs, and influencing factors. Results 37 veterans completed all surveys and participated in recorded interviews. Based on qualitative and quantitative data, veterans’ relation to food and nutrition (i.e., nutritional functioning) was found to be characterized by 5 core constructs, including food background, nutrition knowledge, meal aptitude, resource navigation, and navigation to/of food spaces. Nutritional functioning was found to be shaped by 5 influencing factors, including injuries and health conditions, ideological and cultural exposures, relationships, and current beliefs and behaviors. Conclusions Nutritional functioning (food background, nutrition knowledge, meal aptitude, resource navigation, and navigation to/of food spaces) among injured veterans is complex, and shaped by multiple physical, psychosocial, economic, and cultural factors.