Research brief
Food Insecurity and Gender are Risk Factors for Obesity

https://doi.org/10.1016/j.jneb.2006.08.021Get rights and content

Abstract

Objective

Examine relationships between adult obesity, childhood overweight, and food insecurity.

Design

Cross-sectional retrospective study.

Setting

Community settings in Hartford, Connecticut.

Participants

Convenience sample of 200 parents and their 212 children, aged 2-12.

Main Outcome Measures

Adult obesity (Body Mass Index [BMI] > 30), childhood overweight (BMI-for-age > 95th percentile), and household food security (U.S. Department of Agriculture module).

Analysis

Chi-square tests between weight status and socioeconomic characteristics. Multinomial regression analyses to determine risk factors for adult obesity and childhood overweight.

Results

Over half of parents (51%) were obese, and almost one-third of children (31.6%) were overweight. Over half of households were food insecure. Food insecure adults were significantly more likely to be obese as those who were food secure (Odds Ratio [OR]=2.45, p = .02). Being a girl and having an obese parent doubled the likelihood of children being overweight (OR=2.56, P = .01; OR=2.32, P = .03). Children with family incomes below 100% of poverty were half as likely to be overweight as those with higher incomes (OR=.47, P = .05). Food insecurity did not increase odds of childhood overweight.

Conclusions and Implications

Obesity prevention programs and policies need to address food insecurity and gender as key risk factors.

Introduction

Obesity and food insecurity are both major public health issues related to nutrition. Recent data from the 1999-2002 National Health and Nutrition Examination Survey show that nearly one-third of all adults are classified as obese, and 16% of children ages 6-19 are overweight.1 In addition, overweight children are much more likely to become obese adults and to suffer adverse consequences associated with excess weight, including decreased work productivity, increased health care costs, disability, and premature death.2

Previous studies have suggested a link between obesity and food insecurity (ie, not having access at all times to enough food for an active, healthy lifestyle because food products are not consistently available or households are not consistently able to afford such food products). According to the U.S. Department of Agriculture (USDA) Economic Research Service, 11.9% of U.S. households reported some level of food insecurity in 2004, and food insecurity is strongly linked to income, with households with incomes below the federal poverty line being about 4 times as likely to be food insecure as households with incomes above this level.3 Several studies have shown a relationship between household food insecurity and adult obesity.4, 5 Possible explanations include the fact that high-fat, high-calorie food products cost less than healthful food.6 In addition, food insecure households may experience disrupted eating patterns (feast or famine) that can have metabolic consequences.7

However, there have been a limited number of studies examining childhood overweight and food insecurity, and they have shown conflicting and complex results. A study of Mexican American preschoolers showed no significant association between overweight and food insecurity.8 A study of Hispanic fifth-grade children in California showed a negative association between household food insecurity and the children’s body mass index (BMI).9 Casey and colleagues found significant differences in childhood obesity rates between high-income and low-income groups, but food insufficiency alone was not a significant predictor of obesity among the low-income groups.10 A recent study by Whitaker and Orzol found Hispanic children to be at greater risk of obesity, but they found no significant differences based on food security.11 Although most studies examining the association between obesity and food insecurity have focused on either adults or children, this study included the weight status of parents as a potential risk factor for childhood overweight.

This study was conducted in Hartford, Connecticut, which is the second-poorest medium-sized city in the United States, according to the 2000 Census. Hartford’s population is 40.5% Hispanic, 36% black, and 17.8% white.12 A previous study by the lead author found high rates of food insecurity (52%) in Hartford.13 In 2004, over half (56.2%) of Connecticut’s adults were either obese (19.7%) or overweight (36.5%).14 In a sample of Hartford adolescents using school-based health clinics in the late 1990s, 13% of children entering kindergarten were classified as overweight (BMI-for-age > 95th percentile), and 10% were at risk of overweight (> 85th < 95th percentile).15 By sixth grade, 26% of these children were overweight, and 18% were at risk for overweight.

Growing evidence suggests a relationship between household food insecurity and increased risk of adult obesity. This study examines the relationships between adult obesity, childhood overweight, and household food insecurity in Hartford. The hypotheses of this study are that:

  • 1

    Food insecure adults are more likely to be obese than food secure adults.

  • 2

    Food insecure children are more likely to be overweight than food secure children.

  • 3

    Children with an obese parent are more likely to be overweight than children without an obese parent.

Section snippets

Description of Participants

Data were collected from a convenience sample of 200 parents and their 212 children aged 2-12 in Hartford, Connecticut from December 2003 to September 2004 (the use of the term “parent” in our paper refers to the main caretaker of the child, including birth parents, grandparents, foster parents, and other guardians). Participants were recruited from community settings, including day care centers, family resource centers, health fairs, and community agencies that primarily serve low-income

Characteristics of Participants

The average age of adults was 33.3 years, and for children the average was 5.7 years; 51% of the children were girls. Demographic characteristics of the sample are shown in Table 1. This was a predominantly low-income sample: 64% of families had incomes below poverty, 28% were in extreme poverty (below 50% of poverty), and only 16% had incomes above 185% of poverty. Food insecurity and obesity rates were much higher than national averages. Over half of all households were food insecure,

Discussion

Within this predominantly low-income population in Hartford, Connecticut, there were different risk factors for obesity for parents and children. Among adults, being food insecure was the major risk factor, which adds to a growing body of research corroborating the relationship between food insecurity and adult obesity. To our knowledge, this is the first study to examine both parental and child weight status with food security. Being a girl and having an obese parent significantly increased

Implications for research and practice

There are different risk factors for obesity among adults and children within the same families and environment. Therefore, different prevention strategies are needed to combat adult obesity and childhood overweight. For food insecure adults, strategies that merely increase nutrition awareness may not be sufficient to combat obesity.21 When considering that healthful food products (ie, fruits and vegetables, whole grains, and lean meats) cost more than their less-healthful counterparts, then

Acknowledgments

We thank the families who gave of their time to be interviewed and weighed. We also thank Marcia Fider and Kristen Donato for their help with data collection. We appreciate the thoughtful edits by the three external reviewers who helped improve this document. This research was funded by the USDA, FSNE #04ESS4702.

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This research was funded by the USDA, FSNE #04ESS4702.

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