Didactic Program in Dietetics, Department of Nutrition, Simmons College, Boston, MA 02115, USA.
J Acad Nutr Diet. 2012 Dec;112(12):1949-58. doi: 10.1016/j.jand.2012.08.031.
Obesity 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.
Our 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.
This 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/SETTING: A 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.
Multivariate 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.
Persistent 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.
These 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.
低收入家庭中肥胖及其与家庭食物不安全的共同发生是一个公共卫生问题，尤其是因为两者都与以后的不良健康后果有关。
我们的目的是研究婴儿期和幼儿期家庭食物无保障与饥饿并存与 2 至 5 岁时体重状况之间的关系。
这项纵向研究使用了在第一次婴儿期和最后一次儿童（2 至 5 岁）特殊补充营养计划妇女、婴儿和儿童访问期间收集的家庭食物安全状况、体重和身高数据。家庭粮食安全是根据父母/照顾者对 18 项核心粮食安全模块的四项问题子量表的回答来确定的。肥胖的定义是性别特异性年龄特定的身体质量指数≥95 百分位数。
参与者/设置：参加马萨诸塞州特殊补充营养计划妇女、婴儿和儿童（2001-2006 年）的多样化（58.6%为非白人）低收入样本中的 28353 名儿童；24.9%的婴儿和 23.1%的儿童生活在食物不安全的家庭中，17.1%的儿童在最后一次儿童就诊时肥胖。
多变量逻辑回归分析评估了婴儿期和儿童期家庭粮食安全状况与学龄前肥胖风险之间的关系，同时控制了儿童的种族/西班牙裔、性别、儿童和家庭规模、母亲年龄、教育程度和孕前体重。还检查了这些协变量与家庭粮食安全状况之间的相互作用。在多次比较的情况下，应用了 Bonferroni 校正。
与持续的家庭粮食安全相比，持续的家庭粮食不安全且不饥饿与儿童肥胖的几率增加 22%有关（比值比=1.22；95%置信区间 1.06 至 1.41）（P<0.05）。母亲的孕前体重状况改变了这种关联，对于体重不足（调整后的比值比=3.22；95%置信区间 1.70 至 6.11；P=0.003）或超重/肥胖（调整后的比值比=1.34；95%置信区间 1.11 至 1.62；P=0.03）的母亲来说，与持续的家庭粮食安全相比，有子女的家庭粮食不安全且不饥饿的几率更高。
这些结果表明，持续的家庭粮食不安全且不饥饿与儿童肥胖有关，但这些关联取决于母亲的体重状况。应针对弱势群体进行早期干预，以预防以后生活中的超重和肥胖。
