Household Food Insecurity is Associated with Higher Adiposity among US Schoolchildren Ages 10–15 Years: The Healthy Communities Study

Limited research exists on the relationship between food insecurity and children's adiposity and diet and how it varies by demographic characteristics in the United States. The aim of this study was to assess the relationship between household food insecurity and child adiposity-related outcomes, measured as BMI (kg/m2) z score (BMI-z), weight status, and waist circumference, and diet outcomes, and examined if the associations differ by age, sex, and race/ethnicity. Data collected in 2013–2015 from 5138 US schoolchildren ages 4–15 y from 130 communities in the cross-sectional Healthy Communities Study were analyzed. Household food insecurity was self-reported using a validated 2-item screener. Dietary intake was assessed using the 26-item National Cancer Institute's Dietary Screener Questionnaire, and dietary behaviors were assessed using a household survey. Data were analyzed using multilevel statistical models, including tests for interaction by age, sex, and race/ethnicity. Children from food-insecure households had higher BMI-z (β: 0.14; 95% CI: 0.06, 0.21), waist circumference (β: 0.91 cm; 95% CI: 0.18, 1.63), odds of being overweight or obese (OR: 1.17; 95% CI: 1.02, 1.34), consumed more sugar from sugar-sweetened beverages (β: 1.44 g/d; 95% CI: 0.35, 2.54), and less frequently ate breakfast (β: −0.28 d/wk; 95% CI: −0.39, −0.17) and dinner with family (β: −0.22 d/wk; 95% CI: −0.37, −0.06) compared to children from food-secure households. When examined by age groups (4–9 and 10–15 y), significant relationships were observed only for older children. There were no significant interactions by sex or race/ethnicity. Household food insecurity was associated with higher child adiposity-related outcomes and several nutrition behaviors, particularly among older children, 10–15 y old.