Jansen Erica C, Kasper Nicole, Lumeng Julie C, Brophy Herb Holly E, Horodynski Mildred A, Miller Alison L, Contreras Dawn, Peterson Karen E
Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA.
Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA.
Soc Sci Med. 2017 May;181:168-176. doi: 10.1016/j.socscimed.2017.04.003. Epub 2017 Apr 4.
Children living in households that have recently become food insecure may be particularly vulnerable to adverse weight and dietary changes, but longitudinal studies examining these associations are lacking. Using data from 501 Head Start preschoolers from Michigan (48% male) who were followed during one school year as a part of a randomized obesity prevention trial, we examined changes in children's adiposity indices and dietary quality according to changes in household food insecurity. Household food insecurity change status was categorized as persistently food secure, became food secure, persistently food insecure, or became food insecure. Linear mixed effects models were used to estimate relative changes in BMI-for-age z scores (BAZ), triceps skinfolds-for-age z scores (TAZ), or diet quality (assessed with the 2010 Healthy Eating Index) over the school year according to food insecurity category. We found that girls from households that became food insecure over the year had a 0.21 unit higher gain in BAZ than girls from households that were persistently food secure, after adjustment for potential confounders (95% CI 0.02 to 0.39, P = 0.03). Girls from households that became food secure had improvements in dietary quality over the year compared to girls from persistently food insecure households (adjusted difference in Healthy Eating Index score change = 9.1 points; 95% CI 3.0 to 15.0; p = 0.003). There were no statistically significant associations with changes in TAZ. Among boys, there were no associations between changes in household food insecurity and changes in BAZ, TAZ, or dietary quality. In summary, we found that BMI and diet quality changes of Head Start preschool girls were correlated with short-term changes in household food insecurity. Continued research efforts should focus on identifying the most effective ways to promote the health of children in food insecure households, especially those who may have recently transitioned or are transitioning into food insecurity.
生活在近期出现粮食不安全状况家庭中的儿童，可能特别容易受到体重和饮食不良变化的影响，但缺乏对此类关联进行研究的纵向研究。作为一项随机肥胖预防试验的一部分，我们对来自密歇根州的501名开端计划学龄前儿童（48%为男性）进行了一学年的跟踪研究，根据家庭粮食不安全状况的变化，研究了儿童肥胖指数和饮食质量的变化。家庭粮食不安全状况变化分为持续粮食安全、变为粮食安全、持续粮食不安全或变为粮食不安全。使用线性混合效应模型，根据粮食不安全类别估计一学年内年龄别BMI z评分（BAZ）、年龄别三头肌皮褶厚度z评分（TAZ）或饮食质量（用2010年健康饮食指数评估）的相对变化。我们发现，在调整潜在混杂因素后，一年中变为粮食不安全家庭的女孩BAZ增加量比持续粮食安全家庭的女孩高0.21个单位（95%CI 0.02至0.39，P = 0.03）。与持续粮食不安全家庭的女孩相比，变为粮食安全家庭的女孩在一年内饮食质量有所改善（健康饮食指数得分变化的调整差异=9.1分；95%CI 3.0至15.0；p = 0.003）。TAZ变化无统计学显著关联。在男孩中，家庭粮食不安全状况变化与BAZ、TAZ或饮食质量变化之间无关联。总之，我们发现开端计划学龄前女孩的BMI和饮食质量变化与家庭粮食不安全状况的短期变化相关。持续的研究工作应集中于确定促进粮食不安全家庭儿童健康的最有效方法，特别是那些可能最近已过渡或正在过渡到粮食不安全状况的家庭。
