Chi Donald L, Dinh Mai A, da Fonseca Marcio A, Scott JoAnna M, Carle Adam C
J Acad Nutr Diet. 2015 Oct;115(10):1599-604. doi: 10.1016/j.jand.2015.02.011. Epub 2015 Apr 1.
Tooth decay is the most common childhood disease and it disproportionately affects low-income children. The dietary risk factors associated with socioeconomic status (SES), such as food insecurity and fast-food consumption, are poorly understood.
To better understand how upstream social factors are related to dietary behaviors by testing the hypothesis that food insecurity mediates the SES-fast-food consumption relationship.
A 36-item survey was administered to caregivers of children younger than age 18 years (n=212). The predictor variable was SES, measured by whether the child was insured by Medicaid (no/yes). Food insecurity, the potential dietary mediator, was measured using the six-item US Department of Agriculture Household Food Security Survey (food secure/food insecure without hunger/food insecure with hunger). The outcome variable was whether the household reported eating at a fast-food restaurant ≥2 times a week (no/yes). We used logistic structural equation and mediation models to test our hypothesis.
About 63% of children were classified as low SES. Thirty percent of caregivers reported food insecurity (with or without hunger) and 18.6% of households consumed fast food ≥2 times per week. Lower SES was significantly associated with food insecurity (odds ratio [OR] 3.03, 95% CI 1.51 to 6.04; P=0.002), but SES was not related to fast-food consumption (OR 1.94, 95% CI 0.86 to 4.36; P=0.11). Food insecurity was not associated with fast-food consumption (OR 1.76, 95% CI 0.86 to 3.62; P=0.12). The mediation analyses suggest food insecurity does not mediate the relationship between SES and fast-food consumption. However, there are important potential differences in fast-food consumption by SES and food insecurity status.
Future dietary research focusing on tooth decay prevention in vulnerable children may need to account for the differential effects of SES on food insecurity and dietary behaviors like fast-food consumption. Studies are needed to further elucidate the mechanisms linking SES, dietary behaviors, and tooth decay in children.
龋齿是最常见的儿童疾病，低收入儿童受其影响的比例过高。与社会经济地位（SES）相关的饮食风险因素，如粮食不安全和快餐消费，目前了解甚少。
通过检验粮食不安全介导SES与快餐消费关系这一假设，更好地理解上游社会因素与饮食行为之间的关系。
对18岁以下儿童的照料者进行了一项包含36个条目的调查（n = 212）。预测变量是SES，通过儿童是否有医疗补助保险（无/有）来衡量。粮食不安全作为潜在的饮食中介变量，使用美国农业部六项家庭粮食安全调查进行测量（粮食安全/无饥饿的粮食不安全/有饥饿的粮食不安全）。结果变量是家庭是否报告每周在快餐店就餐≥2次（否/是）。我们使用逻辑结构方程和中介模型来检验我们的假设。
约63%的儿童被归类为低SES。30%的照料者报告存在粮食不安全（有或无饥饿），18.6%的家庭每周消费快餐≥2次。较低的SES与粮食不安全显著相关（优势比[OR] 3.03，95%置信区间1.51至6.04；P = 0.002），但SES与快餐消费无关（OR 1.94，95%置信区间0.86至4.36；P = 0.11）。粮食不安全与快餐消费无关（OR 1.76，95%置信区间0.86至
