The association between food insecurity, diet quality, and untreated caries among US children

Bahanan, Lina; Singhal, Astha; Zhao, Yihong; Scott, Thayer E.; Kaye, Elizabeth Krall

doi:10.1016/j.adaj.2021.03.024

Cited by 7 publications

(35 citation statements)

References 31 publications

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“…Consistent with our main hypothesis, the finding from this nationally representative study of 5-17 year old children was that those living in food insecure households reported having significantly poorer oral health than their food secure counterparts. This finding is also consistent with prior studies reporting on similarly aged children from Brazil (10)(11)(12) and several high-income countries (13)(14)(15)(16)(17)(18)(19) despite differences in study designs, methods used to assess HFI and oral health, and data analysis. The study also provided insights about potential dietary and non-dietary mediators of the HFI-child oral health relationship.…”

Section: Discussionsupporting

confidence: 91%

“…A poor diet, including the excess intake of cariogenic carbohydrate foods, has been suggested by prior authors as a potential mediator of the HFI-oral health relationship in children (13,15,23) . Our parallel mediation analysis results indicated that highly fermentable carbohydrate foods accounted for an estimated 4•3 % of the total effect of HFI on child oral health problems in the parallel mediation analysis.…”

Section: Discussionmentioning

confidence: 98%

“…several high-income countries (13)(14)(15)(16)(17)(18)(19) despite differences in study designs, methods used to assess HFI and oral health and data analysis. The study also provided insights about potential dietary and non-dietary mediators of the HFI-child oral health relationship.…”

Section: Discussionmentioning

confidence: 99%

“…However, the relationship of HFI with oral health is understudied in school-age children especially those from low-and-middle income countries (LMIC). Except for Brazil, (10)(11)(12) published studies are limited to three high-income countries, i.e., the U.S. (13)(14)(15)(16) , New Zealand (17)(18) and South Korea (19) . This is an important gap in knowledge since both the population burdens of HFI (20) and childhood oral disease are elevated in Latin American and other LMICs compared to high-income countries (5,21) .…”

Section: Introductionmentioning

confidence: 99%

“…Food insecure households may be more likely to purchase and consume processed carbohydrate foods because of their cheaper cost and/or use of these to self-medicate or binge eat (22) . The frequent consumption of cheaper highly fermentable carbohydrate foods (e.g., processed snacks, fast foods, sugar-sweetened beverages) has been hypothesized as playing an important potential role in the development of oral disease in children from food insecure households (13,15,23) . This is a plausible hypothesis since such foods are reported to foster oral environments favorable to the development of caries, gingivitis, and other periodontal disease.…”

Section: Introductionmentioning

confidence: 99%

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Food insecurity is associated with self-reported oral health in school-age Ecuadorian children and is mediated by dietary and non-dietary factors

Weigel

Armijos

2022

Public Health Nutr.

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Objective: The main objective was to investigate the association of household food insecurity (HFI) with child oral health. A secondary objective was to explore potential dietary and non-dietary mediators of the HFI-child oral health relationship. Design: Cross-sectional data from the nationally representative Ecuadorian National Health and Nutrition Survey (2018) were analyzed. The data included self-reported child oral health, HFI (Food Insecurity Experience Scale), diet (food frequency questionnaire), and oral care behaviors (toothbrushing frequency, toothpaste use). The association of HFI with the reported number of oral health problems was examined with stereotype logistic regression. Parallel mediation analysis was used to explore potential dietary (highly fermentable carbohydrate foods, plain water) and non-dietary (toothbrushing) mediators of the HFI-oral health relationship. Bias-corrected standard errors and 95% confidence intervals (CI) were obtained using non-parametric bootstrapping (10,000 repetitions). Effect size was measured by percent mediation (PM). Setting: Ecuador Participants: 5-17 year old children (n=23,261) Results: HFI affected 23% of child households. 38.5% of children at least one oral health problem. HFI was associated with a greater number of oral health problems: 1-2 problems (AOR=1.37; 95% CI=1.15,1.58; p=0.0001), 3-4 problems (AOR=2.21; 95% CI=1.98,2.44; p=0.0001), 5-6 problems (AOR=2.57; 95% CI=2.27,2.88; p=0.0001). The HFI-oral health relationship was partially mediated by highly fermentable carbohydrate foods (PM=4.3%), plain water (PM=1.8%), and toothbrushing frequency (PM=3.3%). Conclusions: HFI was associated with poorer child oral health. The HFI-oral health relationship was partially mediated by dietary and non-dietary factors. Longitudinal studies are needed to replicate our findings and investigate the role of other potential mediators.

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