Shanafelt Amy, Hearst Mary O, Wang Qi, Nanney Marilyn S
Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN 55414.
St. Catherine University, St Paul, MN 55105.
J Sch Health. 2016 Jun;86(6):472-80. doi: 10.1111/josh.12397.
Food-insecure (FIS) adolescents struggle in school and with health and mental health more often than food-secure (FS) adolescents. Rural communities experience important disparities in health, but little is known about rural FIS adolescents. This study aims to describe select characteristics of rural adolescents by food-security status.
Baseline analysis using data from a randomized trial to increase school breakfast participation (SBP) in rural Minnesota high schools. Students completed a survey regarding food security, characteristics, and home and school environments. Schools provided academic data and staff measured height and weight. Food security was dichotomized as FS vs FIS. Bivariate analysis, multivariate linear/logistic regression, and testing for interaction of food security and sex were performed.
Food-insecure adolescents reported poorer health, less exercise, had lower grades, and higher SBP (p < .01). Food-insecure adolescents reported marginally fewer barriers (p = .06) and more benefits of breakfast (p = .05). All associations except reported benefits remained significant after adjustment. Interactions were identified with girls' grade point average and with boys' caloric and added sugar intake.
Negative associations among food insecurity and positive youth development are identified in our sample. Policy and environmental strategies should address the complexities of these associations, including exploration of the role of school meals.
与粮食安全（FS）的青少年相比，粮食不安全（FIS）的青少年在学校、健康和心理健康方面面临更多困难。农村社区在健康方面存在重大差异，但对农村粮食不安全青少年的了解甚少。本研究旨在按粮食安全状况描述农村青少年的特定特征。
使用来自一项随机试验的数据进行基线分析，该试验旨在提高明尼苏达州农村高中的学校早餐参与率（SBP）。学生完成了一项关于粮食安全、特征以及家庭和学校环境的调查。学校提供学业数据，工作人员测量身高和体重。粮食安全分为粮食安全组与粮食不安全组。进行了双变量分析、多元线性/逻辑回归以及粮食安全与性别的交互作用检验。
粮食不安全的青少年报告健康状况较差、运动量较少、成绩较低且学校早餐参与率较高（p < 0.01）。粮食不安全的青少年报告的障碍略少（p = 0.06），早餐的益处更多（p = 0.05）。调整后，除报告的益处外，所有关联均保持显著。发现女孩的平均绩点以及男孩的热量和添加糖摄入量存在交互作用。
在我们的样本中确定了粮食不安全与青少年积极发展之间的负相关关系。政策和环境策略应解决这些关联的复杂性，包括探讨学校膳食的作用。
