Institute of Child Development, University of Minnesota-Twin Cities, 51 E River Rd, Minneapolis, MN, 55455, USA.
Department of Pediatrics and Center for Pediatric Obesity Medicine, University of Minnesota Medical School, 2512 S 7th St., Minneapolis, MN, 55454, USA.
Soc Sci Med. 2022 Aug;307:115176. doi: 10.1016/j.socscimed.2022.115176. Epub 2022 Jun 30.
Household food insecurity (FI) is a pressing social, economic and public health issue. However, little is known regarding the effect of FI exposure during the first few years of life, the most active postnatal time for neurobiological and physiological development, on patterns of weight gain during early childhood. It is also unknown whether dietary quality would serve as a pathway through which FI affects children's weight development.
This was a secondary data analysis from a three-year randomized clinical trial with five hundred and thirty-four parent/child dyads. Household FI in the past year was reported by parents at baseline when children were 2-4 years of age using the USDA Household Food Security Survey Module-Six Item Short Form. Children's dietary quality at baseline was measured by the US Department of Agriculture Healthy Eating Index (HEI). Child body mass index (BMI) was measured following standardized protocols at baseline and 12-, 24-, and 36-month follow-up. A latent growth curve model was used to examine 1) the association between baseline FI and sex-and-age-adjusted BMI z-scores in children and 2) the HEI pathway between the FI- BMI association.
FI early in life was associated with higher baseline BMI z-scores. Children who had higher BMI at baseline maintained their higher BMI status over the next three years. Children's dietary intake quality did not explain the association between baseline FI and BMI z-scores.
Early exposure to FI was associated with higher BMI in children as early as two years of age, setting them up for an increased likelihood of persistently high BMI-for-age in later childhood. These data suggest that the first few years may be a critical time for developing obesity risk, calling for policy and practices designed for early intervention of food insecurity.
家庭食物不安全（FI）是一个紧迫的社会、经济和公共卫生问题。然而，人们对生命最初几年暴露于 FI 对儿童早期体重增加模式的影响知之甚少，这是大脑神经生物学和生理发育最活跃的时期。也不知道饮食质量是否会成为 FI 影响儿童体重发育的途径。
这是一项为期三年的随机临床试验的二次数据分析，共有 534 对父母/儿童。在儿童 2-4 岁时，父母通过 USDA 家庭食物安全调查模块-六项目短期形式报告过去一年的家庭 FI。儿童在基线时的饮食质量通过美国农业部健康饮食指数（HEI）进行测量。在基线和 12、24 和 36 个月的随访时，采用标准化方案测量儿童的体重指数（BMI）。采用潜在增长曲线模型检验 1）基线 FI 与性别和年龄调整后的儿童 BMI z 分数之间的关系；2）FI-BMI 关联之间的 HEI 途径。
生命早期的 FI 与较高的基线 BMI z 分数相关。基线 BMI 较高的儿童在接下来的三年中保持了较高的 BMI 状态。儿童的饮食摄入质量并不能解释基线 FI 与 BMI z 分数之间的关联。
早期暴露于 FI 与儿童早在两岁时的较高 BMI 相关联，这使他们在以后的儿童时期持续高 BMI 的可能性增加。这些数据表明，最初几年可能是发展肥胖风险的关键时期，呼吁制定政策和实践，以对食物不安全进行早期干预。
