A Longitudinal Study of Food Insecurity on Obesity in Preschool Children

BackgroundObesity and its co-occurrence with household food insecurity among low-income families is a public health concern, particularly because both are associated with later adverse health consequences.ObjectiveOur aim was to examine the relationship between household food insecurity with and without hunger in infancy and later childhood with weight status at 2 to 5 years.DesignThis longitudinal study uses household food-security status, weight, and height data collected at the first infancy and last child (2 to 5 years) Special Supplemental Nutrition Program for Women, Infants, and Children visits. Household food security was based on parent/caretaker responses to a four-question subscale of the 18-item Core Food Security Module. Obesity was defined as sex-specific body mass index for age ≥95th percentile.Participants/settingA diverse (58.6% non-white) low-income sample of 28,353 children participating in the Massachusetts Special Supplemental Nutrition Program for Women, Infants, and Children (2001-2006); 24.9% of infants and 23.1% of children lived in food-insecure households and 17.1% were obese at their last child visit.Statistical analysisMultivariate logistic regression analyses assessed the association between household food-security status during the infant and child visits, and risk of preschool obesity, while controlling for child race/Hispanic ethnicity, sex, child and household size, maternal age, education, and prepregnancy weight. Interactions between these covariates and household food-security status were also examined. In cases of multiple comparisons, a Bonferroni correction was applied.ResultsPersistent household food insecurity without hunger was associated with 22% greater odds of child obesity (odds ratio=1.22; 95% CI 1.06 to 1.41) compared with those persistently food secure (P<0.05). Maternal prepregnancy weight status modified this association with children of underweight (adjusted odds ratio=3.22; 95% CI 1.70 to 6.11; P=0.003) or overweight/obese (adjusted odds ratio=1.34; 95% CI 1.11 to 1.62; P=0.03) mothers experiencing greater odds of child obesity with persistent household food insecurity without hunger compared with those with persistent household food security.ConclusionsThese results suggest that persistent household food insecurity without hunger is prospectively related to child obesity, but that these associations depend on maternal weight status. Vulnerable groups should be targeted for early interventions to prevent overweight and obesity later in life.     

Association of Food Insecurity and Food Addiction Symptoms: A Secondary Analysis of Two Samples of Low-Income Female Adults

BackgroundHousehold food insecurity persists in the United States and has important implications for health and well-being. Food insecurity in female-identified caregivers is particularly concerning, given its association with their mental health and adverse health outcomes for their children. Food insecurity is associated with disordered eating but, to our knowledge, no prior studies have examined an association between food insecurity and food addiction.ObjectiveOur aim was to examine whether food insecurity is associated with higher food addiction symptom endorsement in low-income female adults.DesignSecondary analysis of baseline data from a quasi-experimental study of a mindfulness-based intervention on gestational weight gain among low-income pregnant individuals and an observational study of low-income families.Participants/settingParticipants in study 1 (n = 208) were English-speaking, low-income pregnant individuals with overweight or obesity, recruited in California from 2011 to 2013. Participants in study 2 (n = 181) were English-speaking, low-income female caregivers for children aged 8 through 10 years, recruited in Michigan from 2018 to 2019. Both studies recruited participants from community health clinics, social service agencies, and online advertisements.Main outcome measuresThe primary outcome measure was food addiction symptoms, assessed by the Yale Food Addiction Scale.Statistical analysisMultivariate Poisson regression was used to examine the association between household food insecurity and food addiction symptoms in each sample, adjusted for sociodemographic characteristics.ResultsIn study 1, pregnant individuals in food-insecure households reported 21% higher food addiction symptoms than pregnant individuals in food-secure households (incidence rate ratio 1.21; 95% CI 1.00 to 1.47; P = .047). In study 2, caregivers in food-insecure households had 56% higher food addiction symptoms than caregivers in food-secure households (incidence rate ratio 1.56; 95% CI 1.01 to 2.40; P = .045).ConclusionsThese findings provide preliminary support for a relationship between household food insecurity and food addiction. Future research should examine potential mechanisms and whether interventions to reduce food insecurity lower risk of food addiction.     

Food Insecurity Increases the Odds of Obesity Among Young Hispanic Children

Obesity is a growing public health concern and is more prevalent among low-income and minority populations. Food insecurity may increase the odds of obesity in children. We investigated the association between food insecurity and obesity among low-income, Hispanic, mother–child dyads (n = 74). The United States Department of Agriculture 18-item Household Food Security Survey was used to determine food security status. The majority of households were food insecure (74 %) and one-third (30 %) of children were obese. Food insecurity increased the odds of childhood obesity (OR 10.2; 95 % CI 1.2, 85.5) with stronger associations found within households where mothers were also overweight/obese compared to normal weight (p-for interaction < 0.05). Rates of household food insecurity and childhood obesity were high among this low-income Hispanic sample. Future studies should elucidate the mechanisms through which food insecurity impacts childhood obesity.     

Nutritional Outcomes Related to Household Food Insecurity among Mothers in Rural Malaysia

During the past two decades, the rates of food insecurity and obesity have risen. Although a relationship between these two seemingly-paradoxical states has not been repeatedly seen in men, research suggests that a correlation between them exists in women. This study examines nutritional outcomes of household food insecurity among mothers in rural Malaysia. A cross-sectional survey of low-income households was conducted, and 223 households with mothers aged 18–55 years, who were non-lactating, non-pregnant, and had at least one child aged 2–12 years, were purposively selected. A questionnaire was administered that included the Radimer/Cornell Scale, items about sociodemographic characteristics, and anthropometric measurements. Of the households, 16.1% were food-secure whereas 83.9% experienced some kind of food insecurity: 29.6% of households were food-insecure, 19.3% contained individuals who were food-insecure, and 35.0% fell into the ‘child hunger’ category. The result reported that household-size, total monthly income, income per capita, and food expenditure were significant risk factors of household food insecurity. Although there was a high prevalence of overweight and obese mothers (52%) and 47.1% had at-risk waist-circumference (≥80 cm), no significant association was found between food insecurity, body mass index, and waist-circumference. In conclusion, the rates of household food insecurity and overweight and obesity were high in the study population, although they are looking paradoxical. Longitudinal studies with larger sample-sizes are recommended to further examine the relationship between food insecurity and obesity.Key words: Household food insecurity, Obesity, Overweight, Malaysia     

Food insecurity is associated with adverse health outcomes among human infants and toddlers

The U.S. Household Food Security Scale, developed with federal support for use in national surveys, is an effective research tool. This study uses these new measures to examine associations between food insecurity and health outcomes in young children. The purpose of this study was to determine whether household food insecurity is associated with adverse health outcomes in a sentinel population ages < or = 36 mo. We conducted a multisite retrospective cohort study with cross-sectional surveys at urban medical centers in 5 states and Washington DC, August 1998-December 2001. Caregivers of 11,539 children ages < or = 36 mo were interviewed at hospital clinics and emergency departments (ED) in central cities. Outcome measures included child's health status, hospitalization history, whether child was admitted to hospital on day of ED visit (for subsample interviewed in EDs), and a composite growth-risk variable. In this sample, 21.4% of households were food insecure (6.8% with hunger). In a logistic regression, after adjusting for confounders, food-insecure children had odds of "fair or poor" health nearly twice as great [adjusted odds ratio (AOR) = 1.90, 95% CI = 1.66-2.18], and odds of being hospitalized since birth almost a third larger (AOR = 1.31, 95% CI = 1.16-1.48) than food-secure children. A dose-response relation appeared between fair/poor health status and severity of food insecurity. Effect modification occurred between Food Stamps and food insecurity; Food Stamps attenuated (but did not eliminate) associations between food insecurity and fair/poor health. Food insecurity is associated with health problems for young, low-income children. Ensuring food security may reduce health problems, including the need for hospitalizations.     

Grandmothers, Fathers, and Depressive Symptoms Are Associated with Food Insecurity among Low-Income First-Time African-American Mothers in North Carolina

African Americans experience household food insecurity, ie, the limited availability of nutritionally adequate and safe food, or ability to acquire acceptable foods in socially acceptable ways, at three times the rate of non-Hispanic whites. Thirty percent of all African-American children live in food-insecure households. The purpose of this study was to identify characteristics associated with household food insecurity among a high-risk postpartum population. Two-hundred six low-income, African-American mother−infant dyads were recruited through the Special Supplemental Nutrition Program for Women, Infants, and Children clinics. The six-item US Department of Agriculture food security scale was used to classify households as food secure, marginally food secure, or food insecure. Multinomial logistic regression was used to estimate the association between selected maternal/household characteristics and household food-security status. Fifty-three percent of households were food secure, 34% were marginally food secure, and 13% were food insecure. Maternal education less than college (relative risk ratio [RRR]=0.46; 95% confidence interval [CI]: 0.22 to 0.98) was inversely associated with marginal food security. Depressive symptoms (RRR=1.09; 95% CI: 1.02 to 1.16) and having the baby's father in the household (RRR=3.46; 95% CI: 1.22 to 9.82) were associated with household food insecurity, while having a grandmother in the household (RRR=0.15; 95% CI: 0.03 to 0.80) was inversely associated with experiencing household food insecurity. Findings from this study suggest that young, low-income, African-American families with only one child are particularly susceptible to experiencing household food insecurity. Intergenerational support and transfer of knowledge can be a key protective attribute among low-income African-American households.     

Food insecurity is highly prevalent and predicts underweight but not overweight in adults and school children from Bogotá, Colombia

The aims of this study were to determine the sociodemographic and dietary correlates of household and child food insecurity in Bogotá, Colombia and to examine whether food insecurity is a risk factor for underweight or overweight in this population. We analyzed data from 2359 families with 2526 children 5-12 y of age who completed a cross-sectional survey conducted in 2006. The survey was representative of low- and middle-income families who had children enrolled in the public primary school system of Bogotá. We used a 16-item food insecurity scale, modified from the United States Household Food Security Survey Module, assessed children's dietary intake with a FFQ, and measured their height and weight. Mothers' anthropometry was obtained through self-report. We estimated adjusted prevalence ratios and 95% CI from binomial regression models. Household food insecurity with hunger and child food insecurity were each positively associated with maternal age, parity, and single parent status and inversely related to mean household income and number of home assets. Animal protein and snack food intake were inversely related to child food insecurity. In multivariate analyses, food-insecure children were 3 times more likely to be underweight than food-secure children (95% CI = 1.6, 5.4; P = 0.0007). Hunger in the household was significantly associated with maternal underweight. Food insecurity was not related to child stunting, child overweight, or maternal overweight. The prevalence of food insecurity in Bogotá is high and related to poverty. Food insecurity does not necessarily predict overweight in countries undergoing the nutrition transition.     

Child-specific food insecurity and overweight are not associated in a sample of 10- to 15-year-old low-income youth

In the United States, 17% of children and adolescents are overweight and 20% live in a food insecure household. Previous studies examining the association between household food insecurity and overweight among children have been inconclusive but are limited insofar as they did not assess child-specific measures of food insecurity and overweight. In response, this study examined the association between food insecurity and child overweight status when these variables were measured for the same child using information on children (n = 1031) aged 10-15 y from the Three-City Study. Approximately 8% of the children were food insecure, whereas 50% were either at risk of overweight or overweight. Bivariate analyses indicated that there were no significant differences in the prevalence of at risk of overweight and overweight between food secure and food insecure children. Gender, race, and income showed similar patterns. Results from logistic regression analyses also indicated that the likelihood of being overweight or at risk of overweight was not significantly different for food secure and food insecure children. Although child-specific food insecurity was not associated with overweight in this sample of low-income children, food insecurity and overweight coexist among these low-income children, because approximately 25% of the food insecure children were overweight. Additional research is needed to explore the potential relationships between food insecurity and overweight and to better inform policy that attempts to address these issues among low-income households with children.     

Hunger and Food Insecurity in Nairobi’s Slums: An Assessment Using IRT Models

Although linked to poverty as conditions reflecting inadequate access to resources to obtain food, issues such as hunger and food insecurity have seldom been recognized as important in urban settings. Overall, little is known about the prevalence and magnitude of hunger and food insecurity in most cities. Yet, in sub-Saharan Africa where the majority of urban dwellers live on less than one dollar a day, it is obvious that a large proportion of the urban population must be satisfied with just one meal a day. This paper suggests using the one- and two-parameter item response theory models to infer a reliable and valid measure of hunger and food insecurity relevant to low-income urban settings, drawing evidence from the Nairobi Urban Health and Demographic Surveillance System. The reliability and accuracy of the items are tested using both the Mokken scale analysis and the Cronbach test. The validity of the inferred household food insecurity measure is assessed by examining how it is associated with households’ economic status. Results show that food insecurity is pervasive amongst slum dwellers in Nairobi. Only one household in five is food-secure, and nearly half of all households are categorized as “food-insecure with both adult and child hunger.” Moreover, in line with what is known about household allocation of resources, evidence indicates that parents often forego food in order to prioritize their children.     

Obesity and household food insecurity: evidence from a sample of rural households in Malaysia

OBJECTIVE:The study examined nutritional outcomes related to body fat accumulation of food insecurity among women from selected rural communities in Malaysia. DESIGN: Cross-sectional study. SETTING: Rural communities (seven villages and two palm plantations) in a district with high percentage of welfare recipients. SUBJECTS AND MEASUREMENTS: Malay (n = 140) and Indian (n = 60) women were interviewed and measured for demographic, socioeconomic, anthropometric, dietary and physical activity information. The women were measured for their body mass index and waist circumference (WC). Energy and nutrient intakes, food group intake and food variety score were analyzed from 24 h dietary recalls and food-frequency questionnaire. Daily physical activity of the women was examined as the number of hours spent in economic, domestic, leisure and sport activities. RESULTS: Using the Radimer/Cornell Hunger and Food Insecurity Instrument, 58% of the women reported some degree of food insecurity (household insecure 14%, adult insecure 9.5% and child hunger 34.5%). In general, food-insecure women had lower years of education, household income and income per capita, more children and mothers as housewives. More than 50% of food-insecure women were overweight and obese than women from food-secure households (38%). Similarly, more food-insecure women (32-47%) had at-risk WC (> or = 88 cm) than food-secure women (29%). Food-insecure women spent significantly more time in domestic and leisure activities than food-secure women. Overweight and abdominal adiposity among the women were associated with a number of independent variables, such as women as housewives, women with more children, larger household size, food insecurity, shorter time spent in economic activities, longer time spent in leisure activities and lower food variety score. After adjusting for factors that are related to both adiposity and food insecurity, women from food-insecure households were significantly more likely to have at-risk WC, but not obese. CONCLUSION: Among this sample of rural women, the relationship between food insecurity and obesity is a complex one, which involves the interaction with other factors. Nevertheless, given that obesity and food insecurity are of public health concerns in the developing nations, the association between the two should be further investigated.     

Assessment of food insecurity among low income households in kuala lumpur using the radimer/cornell food insecurity instrument - a validation study

Food insecurity exists whenever people are not able to access sufficient food at all times for an active and healthy life. This study used the Radimer/Cornell hunger and food insecurity instrument to assess food insecurity and to determine the risk factors and consequences of food insecurity among low-income households in Kuala Lumpur. One hundred and thirty-seven Malay pre-school children (4-6 years old) from Taman Sang Kancil were measured for their weights and heights. Questionnaires were used to collect food security and socioeconomic information on the households. The findings indicated that 34.3% of the households were food secure, while 65.7% experienced some kind of food insecurity, (27.7% households were food insecure, 10.9% individuals were food insecure and 27.0% fell into the child hunger category). The prevalence of underweight, stunting and wasting were 44.5%, 36.5% and 30.7% respectively. The prevalence of high weight-for-height (overweight) was 13.1%. Based on multinomial logistic regression, larger household size (OR=1.418; p<0.01) and lower educational level of mothers (OR=0.749; p<0.01) and fathers (OR=0.802; p<0.05) were found to be significant risk factors for food insecurity. The study, however, did not find any significant difference in children's nutritional status according to household food security levels. It is recommended that for the Malaysian population, the Radimer/Cornell hunger and food insecurity instrument should be modified and further validated with various ethnic groups in a variety of settings. The validation should include the appropriateness of the statements to the target grounds and their different risk factors and outcomes of food insecurity.     

Hunger in legal immigrants in California, Texas, and Illinois

OBJECTIVES: This study determined the prevalence of food insecurity and hunger in low-income legal immigrants. METHODS: We conducted a cross-sectional survey of Latino and Asian legal immigrants attending urban clinics and community centers in California, Texas, and Illinois with a food security questionnaire. RESULTS: Among 630 respondents, 40% of the households were food insecure without hunger and 41% were food insecure with hunger. Independent predictors of hunger were income below federal poverty level (odds ratio [OR] = 2.72, 95% confidence interval [CI] = 1.72, 4.30), receipt of food stamps (OR = 2.53, 95% CI = 1.57, 4.09), Latino ethnicity (OR = 2.39, 95% CI = 1.49, 3.82), and poor English (OR = 1.76, 95% CI = 1.10, 2.82). CONCLUSIONS: The prevalence of hunger among low-income legal immigrants is unacceptably high. Access to food assistance programs is important for the health and well-being of this population.     

A Longitudinal Study of WIC Participation on Household Food Insecurity

We examined the association between women’s/children’s duration of WIC participation and household food security status. For mothers (n = 21,863) and their children (n = 57,377) participating in WIC (2001–2006), longitudinal measures of household food security status were collected using a subscale of the USDA Food Security Module. Using logistic regression, household food security status at the last WIC visit was associated with measures of WIC duration (number of trimesters on WIC for pregnant women, and number of WIC visits for children). Among women with prenatal household food insecurity with hunger, odds of any post-partum household food insecurity was reduced with first (AOR = 0.67, 95% CI = 0.48–0.94) or second trimester of entry (AOR = 0.64, 95% CI = 0.45–0.90) versus third. Among children with initial household food insecurity without hunger, an additional WIC visit reduced the odds of any household food insecurity (AOR = 0.92, 95% CI = 0.90–0.94) and of household food insecurity with hunger (AOR = 0.94, 95% CI = 0.89–0.98) at the last visit. Among those with initial household food insecurity with hunger, an additional WIC visit reduced the odds of any household food insecurity (AOR = 0.96, 95% CI = 0.92–0.99) and of household food insecurity with hunger (AOR = 0.88, 95% CI = 0.83–0.94) at the last visit. Earlier and longer WIC participation may improve household food security status, particularly of vulnerable groups.     

Food insecurity of low-income lone mothers and their children in Atlantic Canada

OBJECTIVE: To examine the occurrence and predictors of hunger and food insecurity over the past year and month among low-income mother-led households in Atlantic Canada. METHOD: The Cornell-Radimer Questionnaire to Estimate the Prevalence of Hunger and Food Insecurity was administered weekly for a month, with modifications, to a community sample of 141 lone mothers who took part in a larger dietary intake study. Eligible women included those living alone with at least two children under the age of 14 years in the four Atlantic Provinces and having an annual income less than or equal to Statistics Canada's low-income cut-off. RESULTS: Food insecurity over the past year occurred in 96.5% of households. Child hunger was similar to maternal hunger over the one-month study period (23%), however, it was lower than maternal hunger over the past year. On multiple logistic regression analysis, maternal hunger over the past year was predicted by maternal age over 35 years (p < 0.0005), and Nova Scotia residence (p = 0.03). Child hunger over the past year was also predicted by maternal age over 35 years (p = 0.009). Families from New Brunswick experienced less food insecurity over the past month at both the household (p = 0.01) and maternal levels (p < 0.0005). DISCUSSION: Provincial policies that might contribute to the regular occurrence of food insecurity in these families should be investigated.     

Association between household food insecurity and nutritional outcomes among children in Northeastern of Peninsular Malaysia

BACKGROUND/OBJECTIVES

The purpose of the study was to investigate the relationship between household food insecurity and nutritional status of children in low-income households. A cross sectional study involved a survey of households (n = 223) receiving the financial assistance.

SUBJECTS/METHODS

Eligible mothers that fulfilled the inclusion criteria such as non-pregnant, non-lactating mothers, aged 18 to 55 years with their youngest children aged 2 to 12 years, were purposively selected. The Radimer/Cornell hunger and food-insecurity instrument was administered and children''s height and weight were measured.

RESULTS

About 16.1% of the households were food secure, while 83.9% experienced some kind of food insecurity. Out of food insecure category, 29.6% households were food insecure, 19.3% women were individual food insecure and 35.0% fell into the child hunger category. Education of the mother (P = 0.047), household size (P = 0.024), number of children (P = 0.024), number of children going to school (P = 0.048), total monthly income (P < 0.001), income per capital (P < 0.001), number of household members contributing to the income (P = 0.018) and food expenditure (P = 0.006) were significant risk factors for household food insecurity. The prevalence of underweight, stunting and wasting in children were 61.0%, 61.4% and 30.6% respectively. Based on multinomial logistic regression, children in food-insecure households were 2.15 times more likely to be underweight and three times to be stunted than children in the food-secure households.

CONCLUSIONS

The findings suggest that household food insecurity is associated with the nutritional status of the children in the rural area of Northeastern Peninsular Malaysia.     

Relationship between food insecurity and body composition in Ugandans living in urban Kampala

The aim of this pilot study was to document the association between food insecurity and body composition among men and women from urban Kampala (Uganda, East Africa) with an emphasis on the potential discrepancy between the sexes. A convenience sample of 60 food secure subjects (30 males and 30 females) and 60 food insecure subjects (30 males and 30 females) matched by age between sexes and categories were tested at home by trained research assistants. To categorize the subjects as food secure or food insecure, the Radimer/Cornell Hunger and Food Insecurity instrument was used. The percentage of overweight/obesity was 31.2% and 66.3% for food insecure men and women, respectively. Only food insecure women were significantly more likely to be overweight (ie, body mass index > or = 25; crude odds ratio=2.3, confidence interval: 1.2 to 3.4) or to have at-risk waist circumference (ie, waist circumference > or = 88 cm; crude odds ratio=2.3, confidence interval: 1.2 to 3.7) compared to their food-secure counterparts. However, after adjusting for potentially confounding effects of several environmental factors, the risk for food insecure women to be overweight or to have at-risk waist circumference was not significant, suggesting that the potential impact of food insecurity is partly expressed via variations of these factors.     

Food Insecurity Was Associated with Lower Fruits and Vegetables Consumption but Not with Overweight and Obesity in Children from Mexican Fishing Communities

ABSTRACT

Food insecurity has been associated with decreased household food supplies, which could affect children’s fruit and vegetables intakes and increases their risk of being overweight or obese. The aim of this study was to determine if food insecurity was associated with lower fruit and vegetables consumption and overweight and obesity in children from Mexican fishing communities. A cross-sectional study was 4conducted with 100 elementary-school children aged 6–12 years. A survey that evaluated socioeconomic conditions, food insecurity, and fruits and vegetables consumption was applied. Weight and height were measured. The association between key variables and food insecurity was assessed using linear regression. Sixty-four percent of households experienced food insecurity. Food-insecure children reported lower consumption of fruits and fruits plus vegetables than did their peers with food security (P trend = 0.040 and 0.038, respectively). Food insecurity was also associated with lower chance to meet the recommendation of fruit and vegetable consumption (P trend in logit < 0.001), but was negatively associated with the prevalence of overweight and obesity (P trend in logit < 0.001). Food-insecure children had lower fruits and vegetables consumption but were no more likely to be overweight or obese than their food-secure counterparts.     

Social capital is associated with decreased risk of hunger

This article explores whether social capital-a measure of trust, reciprocity and social networks-is positively associated with household food security, independent of household-level socioeconomic factors. Interviews were conducted in 330 low-income households from Hartford, Connecticut. Social capital was measured using a 7-item Likert scale and was analyzed using household- and community-level scores. Household food security and hunger were measured using the US Household Food Security Module. chi2 tests were used to examine associations between social capital, food security and household demographic characteristics. Logistic regression was used to examine whether household- and community-level social capital decreases the odds of household hunger, and to estimate which household characteristics increase the likelihood of having social capital. Consistent with our hypotheses, social capital, at both the household and community levels, is significantly associated with household food security in these data. Community-level social capital is significantly associated with decreased odds of experiencing hunger (adjusted odds ratio (AOR)=0.47 [95% CI 0.28, 0.81], P<0.01), while controlling for household socioeconomic status. Results show that households with an elderly member are over two and a half times as likely to have high social capital (AOR=2.68 [1.22, 5.87], P<0.01) than are non-elderly households, after controlling for socioeconomic status. Having a household member who participates in a social or civic organization is also significantly associated with having higher levels of social capital. Social capital, particularly in terms of reciprocity among neighbors, contributes to household food security. Households may have similarly limited financial or food resources, but households with higher levels of social capital are less likely to experience hunger.