Purpose: Conflicting relationships exist between children’s food insecurity and adiposity and there is limited understanding of how this may vary based on child demographics in the U.S. This study assessed the relationship between household food insecurity and child adiposity-related outcomes, measured as body mass index 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 5,138 US schoolchildren ages 4-15 years 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 (NCI) Dietary Screener Questionnaire (DSQ), and dietary behaviors were assessed using a household survey. Multilevel statistical models were used that included tests for interaction by age, sex, and race/ethnicity.

Results: Compared to children from food secure households, 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), and 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/day; 95% CI: 0.35, 2.54), and less frequently ate breakfast (β=-0.28 days/week; 95% CI: -0.39, -0.17) and dinner with family (β=-0.22 days/week; 95% CI: -0.37, -0.06). When examined by age group (4-9, 10-15 years), 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 years old.

Purpose: We investigate the role of community food environment as a moderator in the associations of household Supplemental Nutrition Assistance Program (SNAP)  status with (1) children’s dietary patterns and (2) household food insecurity.

Methods: Data were collected from 2,211 households with 3-18 year olds in four high poverty, high minority cities. Information was collected on household demographics, SNAP participation, and food insecurity status. Dietary data for one randomly selected child was collected using validated measures. Food environment was assessed as the presence of different types of retail stores (convenience stores, upgraded convenience stores, supermarkets, and small grocery stores) within close proximity (¼ and ½ mile) of a child’s home. Multivariable models with interaction terms examined associations between key exposure (SNAP participation) and outcome variables and investigated whether these associations were moderated by the food environment.

Results: More than a third of the children lived in SNAP participating households and a fifth were food insecure. In multivariable analysis, there were no differences in consumption patterns of children from income-eligible households based on SNAP participation status. Children from income-ineligible households consumed sugary beverages 22% less frequently (p<0.001) and energy-dense snacks 16% less frequently (<0.05) than children from SNAP households. Proximity to a small grocery store selling a selection of healthy items was associated with higher fruit consumption, but only for children from SNAP-participating households(18% higher, p<0.05); fruit consumption was not different based on proximity to healthy stores for children from income-eligible non-SNAP households or for those from income-ineligible households. SNAP-participating households were less food-secure than income-ineligible households (p<0.001), but there were no differences between income-eligible households by SNAP participation status. These relationships were not modified by proximity to different types of food outlets.    

Conclusions: Compared to all non-participating children, children from SNAP households consumed more fruit when they lived close to a healthy food outlet. Programs promoting access to healthy foods among SNAP household may yield positive outcomes. 

Purpose: Conflicting relationships exist between children’s food insecurity and adiposity and there is limited understanding of how this may vary based on child demographics in the U.S. This study assessed the relationship between household food insecurity and child adiposity-related outcomes, measured as body mass index 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 5,138 US schoolchildren ages 4-15 years 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 (NCI) Dietary Screener Questionnaire (DSQ), and dietary behaviors were assessed using a household survey. Multilevel statistical models were used that included tests for interaction by age, sex, and race/ethnicity.

Results: Compared to children from food secure households, 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), and 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/day; 95% CI: 0.35, 2.54), and less frequently ate breakfast (β=-0.28 days/week; 95% CI: -0.39, -0.17) and dinner with family (β=-0.22 days/week; 95% CI: -0.37, -0.06). When examined by age group (4-9, 10-15 years), 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 years old.