|Mccabe Sellers, Beverly|
Submitted to: American Academy of Pediatrics
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 4/13/2006
Publication Date: 11/1/2006
Citation: Casey, P.H., Simpson, P.M., Gossett, J.M., Bogle, M.L., Champagne, C.M., Connell, C., Harsha, D., McCabe Sellers, B.J., Robbins, J.M., Stuff, J.E., Weber, J. 2006. The association of child and household food insecurity with childhood overweight status. Pediatrics. 118(5):e1406-e1413. Interpretive Summary: In recent decades, the prevalence of obese and overweight children has increased at an alarming rate. One factor suggested to influence this rate is an association with food insecurity, defined as limited or uncertain access to enough nutritious food. The purpose of this study was to determine if household and child food insecurity were related to childhood overweight status. The National Health and Nutrition Examination Survey (NHANES) 1999-2002 collected a variety of measurements from a large sample planned to represent the overall citizenry. Children ages 3 to 17 were included. From actual height and weight measurements, Body Mass Index (BMI) was calculated, and upper categories were termed at-risk for overweight (those whose weights were above 85% of other children for their age) or overweight (those who were above 90% of other children for their age). Food security and insecurity were based on answers to the USDA Food Security Scale Module. When comparing children from food-secure households with those from food-insecure households, children from food-insecure household were at more risk for being overweight. Other factors that increased the risks for overweight status included being 12-17 years of age, being female, being white, and living in households with income less than 100% of the official poverty level. In young children aged 3-5 years, being male and being Mexican American were also indicators for being at higher risk for overweight status. If factors such as ethnicity, gender, age, and family poverty index were controlled for mathematically, childhood food insecurity was still an important predictor of being at risk for overweight or being overweight.
Technical Abstract: The prevalence of childhood obesity increased for decades, and some have suggested that childhood overweight is associated with food insecurity, defined as limited or uncertain access to enough nutritious food. The purpose was to assess the association of household and child food insecurity with childhood overweight status. The National Health and Nutrition Examination Survey (NHANES) 1999-2002 uses a stratified multi-staged probability sample and collects a broad array of data from a nationally representative sample of US citizens. All children, ages 3 to 17 years in this sample, are included in these analyses. Measures used were BMI categorized as at-risk for overweight or greater (</=85%) or overweight (</=95%), and household and child food security/insecurity as categorized by the USDA Food Security Scale Module. When compared to children from food-secure households, children from food insecure households were more likely to demonstrate significant associations with at risk for overweight or greater (p</=0.05) in the following demographic categories: 12 to 17 years, females, white, and in households with income less than 100% of the federal poverty level. Childhood food insecurity demonstrated the same associations but is also associated (p</=0.05) with overweight status or greater in 3- to 5-year-old children, males, and Mexican American children. Controlling for ethnicity, gender, age, and family poverty index level, childhood food insecurity is associated (p=0.03) with child at risk for overweight status or greater.