Household Food Insecurity is Associated with Higher Adiposity among US Schoolchildren Ages 10-15 Years: The Healthy Communities Study

Lauren E Au; Sonya M Zhu; Lilly A Nhan; Kaela R Plank; Edward A Frongillo; Barbara A Laraia; Klara Gurzo; Lorrene D Ritchie

doi:10.1093/jn/nxz108

Household Food Insecurity is Associated with Higher Adiposity among US Schoolchildren Ages 10-15 Years: The Healthy Communities Study

J Nutr. 2019 Sep 1;149(9):1642-1650. doi: 10.1093/jn/nxz108.

Authors

Lauren E Au¹, Sonya M Zhu², Lilly A Nhan³, Kaela R Plank¹, Edward A Frongillo⁴, Barbara A Laraia⁵, Klara Gurzo⁶, Lorrene D Ritchie¹

Affiliations

¹ Nutrition Policy Institute, Division of Agriculture and Natural Resources, University of California, Berkeley, CA, USA.
² Maternal, Child, and Adolescent Health Program, School of Public Health, University of California, Berkeley, CA, USA.
³ Department of Community Health Sciences, University of California Los Angeles Fielding School of Public Health, Los Angeles, CA, USA.
⁴ Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, SC, USA.
⁵ Public Health Nutrition Program, School of Public Health, University of California, Berkeley, CA, USA.
⁶ Department of Public Health Sciences, Stockholm University, Stockholm, Sweden.

Abstract

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.

Keywords: adiposity; children; dietary behaviors; dietary intake; food insecurity; obesity.

Publication types

Research Support, N.I.H., Extramural

MeSH terms

Adiposity*
Adolescent
Body Mass Index
Body Weight
Child
Child, Preschool
Cross-Sectional Studies
Diet
Female
Food Supply*
Humans
Male
Waist Circumference

Grants and funding

K01 HL131630/HL/NHLBI NIH HHS/United States