Background Limited research exists on the relationship between food insecurity and children's adiposity and diet and how it varies by demographic characteristics in the United States. Objective The aim of this study was to assess the relationship between household food insecurity and child adiposity-related outcomes, measured as BMI (kg/m2) z score (BMI-z), weight status, and waist circumference, and diet outcomes, and examined if the associations differ by age, sex, and race/ethnicity. Methods Data collected in 2013–2015 from 5138 US schoolchildren ages 4–15 y from 130 communities in the cross-sectional Healthy Communities Study were analyzed. Household food insecurity was self-reported using a validated 2-item screener. Dietary intake was assessed using the 26-item National Cancer Institute's Dietary Screener Questionnaire, and dietary behaviors were assessed using a household survey. Data were analyzed using multilevel statistical models, including tests for interaction by age, sex, and race/ethnicity. Results Children from food-insecure households had higher BMI-z (β: 0.14; 95% CI: 0.06, 0.21), waist circumference (β: 0.91 cm; 95% CI: 0.18, 1.63), odds of being overweight or obese (OR: 1.17; 95% CI: 1.02, 1.34), consumed more sugar from sugar-sweetened beverages (β: 1.44 g/d; 95% CI: 0.35, 2.54), and less frequently ate breakfast (β: −0.28 d/wk; 95% CI: −0.39, −0.17) and dinner with family (β: −0.22 d/wk; 95% CI: −0.37, −0.06) compared to children from food-secure households. When examined by age groups (4–9 and 10–15 y), significant relationships were observed only for older children. There were no significant interactions by sex or race/ethnicity. Conclusions Household food insecurity was associated with higher child adiposity-related outcomes and several nutrition behaviors, particularly among older children, 10–15 y old.
Objectives This study assesses the relationship between household food insecurity and adiposity, measured as BMI-for-age z-score (BMI-z), overweight/obesity, and waist circumference, as well as dietary intake and diet-related behaviors in US children. Methods A total of 5138 US schoolchildren ages 4–15 years from 130 communities in the cross-sectional Healthy Communities Study were included in this analysis. Household food insecurity was self-reported using a validated 2-item screener. Dietary intake was assessed using National Cancer Institute's (NCI) Dietary Screener Questionnaire (DSQ), a 26-item food frequency questionnaire, and dietary behaviors were assessed during a household survey. Data were analyzed using multilevel statistical models, including interaction tests for age, sex, and race/ethnicity. Results Food insecure children had a BMI z-score of 0.14 higher (95% CI: 0.06, 0.21) and a waist circumference of 0.91 cm higher (95% CI: 0.18, 1.63) than food secure children. Food insecure children have 1.17 times the odds of being overweight/obesity compared with food secure children (95% CI: 1.02, 1.34). There was no significant interaction by sex or race/ethnicity. Food insecure children consumed more sugar from sugar sweetened beverages (0.36 tsp/day; 95% CI: 0.09, 0.63), and ate breakfast (−0.28 days/week; 95% CI: −0.39, −0.17) and together with family (−0.22 days/week; 95% CI: −0.37, −0.06) less frequently compared to food secure children. Conclusions The present study found a significant, positive association between household food insecurity and child adiposity for children ages 10–15 years, as well as for several dietary intake and diet-related behaviors. This research helps disentangle the complex picture of food insecurity as a contributor to childhood obesity and poorer dietary outcomes in diverse populations. Funding Sources Research was supported by the National Heart, Lung, and Blood Institute of the National Institutes of Health under award number K01HL131630. The authors would also like to acknowledge the Global Food Initiative at the University of California Office of the President for their support of this project.
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