Published online September 1, 2008
PEDIATRICS Vol. 122 No. 3 September 2008, pp. e529-e540 (doi:10.1542/peds.2008-0556)
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ARTICLE

Food Security, Maternal Stressors, and Overweight Among Low-Income US Children: Results From the National Health and Nutrition Examination Survey (1999–2002)

Craig Gundersen, PhDa, Brenda J. Lohman, PhDb, Steven Garasky, PhDb, Susan Stewart, PhDc and Joey Eisenmann, PhDd

a Department of Agricultural and Consumer Economics, University of Illinois, Urbana, Illinois
b Departments of Human Development and Family Studies
c Sociology, Iowa State University, Ames, Iowa
d Departments of Kinesiology and Pediatrics, Michigan State University, East Lansing, Michigan

OBJECTIVE. A high proportion of children in the United States are overweight, suffer from food insecurity, and live in households facing maternal stressors. The objective of this article was to identify the associations of food insecurity and maternal stressors with childhood overweight among low-income children. We hypothesized that maternal stressors may exacerbate the relationship between food insecurity and child obesity.

METHODS. The sample included 841 children (3–17 years old) and their mothers with incomes below 200% of the poverty line from the 1999–2002 National Health and Nutrition Examination Survey. Food insecurity was based on US Department of Agriculture protocol, maternal stressors were assessed from survey questions, and BMI was used to classify weight status. Probit regression models predicted the probability of a child being overweight or obese.

RESULTS. In most specifications, there was no direct association between food insecurity or maternal stressors and overweight for children of any age. Among 3- to 10-year-olds, the interaction of food insecurity and maternal stressors was significantly linked to the probability of being overweight; more specifically, an increase in maternal stressors amplified a food secure child's probability of being overweight or obese. This result is robust to alternative specifications. However, these results were not found among 11- and 17-year-old youth.

CONCLUSIONS. Younger children in food secure, low-income households in the United States who are experiencing higher levels of maternal stressors have a greater probability of being overweight than food insecure children. This finding was contrary to the hypothesis; 3 reasons for this are covered in the article. Those who create policies that address childhood obesity could consider the benefits to low-income children's well-being resulting from reducing their mothers' stressors. Because most children in the United States are food secure, these policies could have a profound impact on childhood overweight.

Key Words: food insecurity • childhood overweight • poverty • stressors • NHANES

Abbreviations: NHANES—National Health and Nutrition Examination Survey • NCHS—National Center for Health Statistics • CDC—Centers for Disease Control and Prevention • CPS—Current Population Survey • USDA—US Department of Agriculture • ADL—activities of daily living • CI—confidence interval

Accepted Jun 3, 2008.


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C. Gundersen, S. Garasky, and B. J. Lohman
Food Insecurity Is Not Associated with Childhood Obesity as Assessed Using Multiple Measures of Obesity
J. Nutr., June 1, 2009; 139(6): 1173 - 1178.
[Abstract] [Full Text] [PDF]