Published online November 1, 2006
PEDIATRICS Vol. 118 No. 5 November 2006, pp. e1406-e1413 (doi:10.1542/peds.2006-0097)
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ARTICLE

The Association of Child and Household Food Insecurity With Childhood Overweight Status

Patrick H. Casey, MDa, Pippa M. Simpson, PhDa, Jeffrey M. Gossett, MSa, Margaret L. Bogle, PhDb, Catherine M. Champagne, PhDc, Carol Connell, PhDd, David Harsha, PhDc, Beverly McCabe-Sellers, PhDb, James M. Robbins, PhDa, Janice E. Stuff, PhDe and Judith Weber, PhDa

a Department of Pediatrics, College of Medicine, University of Arkansas for Medical Sciences and Arkansas Children's Hospital Research Institute, Little Rock, Arkansas
b Delta Nutrition Intervention Research Initiative, US Department of Agriculture, Agricultural Research Service, Little Rock, Arkansas
c Pennington Biomedical Research Center, Baton Rouge, Louisiana
d Nutrition and Food Systems, College of Health, University of Southern Mississippi, Hattiesburg, Mississippi
e Children's Nutrition Research Center, Baylor College of Medicine, Houston, Texas

CONTEXT. The prevalence of childhood overweight status is increasing. Some have suggested that childhood overweight is associated with food insecurity, defined as limited or uncertain access to enough nutritious food.

OBJECTIVES. The purpose of this work was to assess the association of household and child food insecurity with childhood overweight status.

METHODS. The National Health and Nutrition Examination Survey 1999–2002 uses a stratified multistaged probability sample and collects a broad array of data from a nationally representative sample of US citizens. All children 3 to 17 years old in this sample are included in these analyses. We measured BMI categorized as at risk for overweight or greater (≥85%) or overweight (≥95%) and household and child food security/insecurity using the US Food Security Scale.

RESULTS. When compared with children from food-secure households, children from food-insecure households were more likely to demonstrate significant associations with being at risk for overweight or greater in the following demographic categories: 12 to 17 years, girls, white, and in households with income <100% and >4 times the federal poverty level. Household food insecurity is associated with child overweight status in children aged 12 to 17, girls, and children who live in households with incomes >4 times the federal poverty level. Child food insecurity demonstrated the same associations with being at risk for overweight or greater, as did household food insecurity, but associations were also seen in 3- to 5-year-old children, boys, and Mexican American children. Child food insecurity is significantly associated with child overweight status for children aged 12 to 17, girls, white children, and children in families with income ≤100% poverty level. Controlling for ethnicity, gender, age, and family poverty index level, childhood food insecurity is associated with a child being at risk for overweight status or greater, but not overweight status.

CONCLUSIONS. Household and child food insecurity are associated with being at risk for overweight and overweight status among many demographic categories of children. Child food insecurity is independently associated with being at risk for overweight status or greater while controlling for important demographic variables. Future longitudinal research is required to determine whether food insecurity is causally related to child overweight status.

Key Words: food insecurity • child health status • overweight children

Abbreviations: OW—overweight • ARO—at risk for overweight or greater • NHANES—National Health and Nutrition Examination Survey

Accepted Jun 6, 2006.




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