1 Division of Diabetes and Endocrinology, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN.
2 Center for Pediatric Obesity Medicine, University of Minnesota Medical School, Minneapolis, MN.
Child Obes. 2019 Jul;15(5):298-305. doi: 10.1089/chi.2018.0333. Epub 2019 May 15.
Food insecurity may trigger eating behaviors that contribute to pediatric obesity. The aim of this study is to identify eating behaviors among a pediatric population with obesity and household food insecurity. A cross-sectional study analyzed Child Eating Behavior Questionnaire (CEBQ) and household food insecurity screener responses, and BMI measurements from pediatric participants with obesity (BMI ≥95th percentile) from a weight management clinic between 2013 and 2017. Multivariate linear regression was performed to evaluate associations between CEBQ eating domains [Food Responsiveness, Emotional Overeating, Enjoyment of Food, Desire to Drink (DD), Satiety Responsiveness, Slowness in Eating, Emotional Undereating (EUE), and Food Fussiness] and household food insecurity, adjusting for age, sex, race/ethnicity, SNAP participation, and BMI percentile. A sub-group analysis was performed on participants from food insecure (FI) households to evaluate the associations between SNAP participation and eating domains. Eight hundred twenty-two participants were included in the final analysis. Participants from FI households had significantly higher BMI percentiles even after adjustment for age, sex, race/ethnicity, and SNAP status ( = 0.000). Household food insecurity was associated with increased DD beverages ( = 0.000). Among participants from FI households, SNAP participation was significantly positively associated with the EUE ( = 0.009). Youth from FI households have higher BMIs even among a population with obesity. DD is positively associated with household food insecurity and may contribute to obesity in this population. Results suggest that providers treating pediatric patients with obesity should consider regularly screening for household food insecurity and associated eating behaviors as part of their medical management of obesity.
食物不安全可能会引发导致小儿肥胖的进食行为。本研究旨在确定肥胖和家庭食物不安全的儿科人群中的进食行为。一项横断面研究分析了儿童饮食行为问卷（CEBQ）和家庭食物不安全筛查器的反应以及 2013 年至 2017 年间肥胖（BMI≥95 百分位）的小儿参与者的 BMI 测量值。进行了多变量线性回归，以评估 CEBQ 饮食领域（食物反应性，情绪性暴食，对食物的享受，渴望饮水（DD），饱腹感反应性，进食缓慢，情绪性进食不足（EUE）和对食物的挑剔）与家庭食物不安全之间的关联，调整了年龄，性别，种族/族裔，SNAP 参与情况和 BMI 百分位数。对来自食物不安全（FI）家庭的参与者进行了亚组分析，以评估 SNAP 参与与饮食领域之间的关系。最终分析包括 822 名参与者。即使在调整了年龄，性别，种族/族裔和 SNAP 状态后，FI 家庭的参与者的 BMI 百分位数仍明显较高（ = 0.000）。家庭食物不安全与 DD 饮料增加有关（ = 0.000）。在 FI 家庭的参与者中，SNAP 参与与 EUE 呈显著正相关（ = 0.009）。来自 FI 家庭的年轻人即使在肥胖人群中也具有较高的 BMI。DD 与家庭食物不安全呈正相关，可能导致该人群肥胖。结果表明，治疗小儿肥胖症患者的提供者应考虑定期筛查家庭食物不安全及其相关的进食行为，作为其肥胖症医疗管理的一部分。
