Milken Institute School of Public Health.
Sumner M. Redstone Center for Prevention and Wellness, The George Washington University, Washington, District of Columbia.
Pediatrics. 2022 Jul 1;150(1). doi: 10.1542/peds.2021-055571.
Addressing food insecurity while promoting healthy body weights among children is a major public health challenge. Our objective is to examine longitudinal associations between food insecurity and obesity in US children aged 1 to 19 years.
Sources for this research include PubMed, CINAHL, and Scopus databases (January 2000 to February 2022). We included English language studies that examined food insecurity as a predictor of obesity or increased weight gain. We excluded studies outside the United States and those that only considered the unadjusted relationship between food security and obesity. Characteristics extracted included study design, demographics, methods of food security assessment, and anthropometric outcomes.
Literature searches identified 2272 articles; 13 met our inclusion criteria. Five studies investigated the relationship between food insecurity and obesity directly, whereas 12 examined its relationship with body mass index or body mass index z-score. Three studies assessed multiple outcomes. Overall, evidence of associations between food insecurity and obesity was mixed. There is evidence for possible associations between food insecurity and obesity or greater weight gain in early childhood, for girls, and for children experiencing food insecurity at multiple time points. Heterogeneity in study methods limited comparison across studies.
Evidence is stronger for associations between food insecurity and obesity among specific subgroups than for children overall. Deeper understanding of the nuances of this relationship is critically needed to effectively intervene against childhood obesity.
解决儿童的粮食不安全问题，同时促进其健康体重，是一项重大的公共卫生挑战。本研究旨在检验美国 1 至 19 岁儿童中粮食不安全与肥胖之间的纵向关联。
本研究的资料来源包括 PubMed、CINAHL 和 Scopus 数据库（2000 年 1 月至 2022 年 2 月）。我们纳入了研究粮食不安全作为肥胖或体重增加预测因素的英文文献。排除了美国以外的研究以及仅考虑粮食安全与肥胖之间未调整关系的研究。提取的特征包括研究设计、人口统计学、粮食安全评估方法和人体测量学结果。
文献检索共识别出 2272 篇文章，其中 13 篇符合纳入标准。五项研究直接调查了粮食不安全与肥胖之间的关系，而 12 项研究则考察了其与体重指数或体重指数 z 分数的关系。三项研究评估了多个结局。总体而言，粮食不安全与肥胖之间关联的证据不一。有证据表明，粮食不安全与肥胖或幼儿期体重增加较多、女孩以及在多个时间点经历粮食不安全的儿童之间可能存在关联。研究方法的异质性限制了研究之间的比较。
与儿童整体相比，粮食不安全与肥胖之间的关联在某些特定亚组中证据更为确凿。为了有效干预儿童肥胖，迫切需要深入了解这种关系的细微差别。
