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Early childhood food insecurity associated with poor health and development, not obesity



1. Young children in food insecure households are more likely to report fair or poor health and development risks to caregivers than children in food-poor households.

2. There was a significant relationship between food insecurity and obesity in only one age group; otherwise, there was no association between food insecurity and obesity, overweight, and confinement among young children.

Level of Evidence Rating: 2 (Good)

Study Program: Food insecurity is a public health problem among children, and studies examining the links between food insecurity and weight have yielded incompatible results. In addition, previous studies have not stratified by age or distinguished between household food insecurity and child insecurity. In this cross-sectional study, researchers used data from studies conducted among parents of children <4 years of age. Surveys measure nutritional insecurity, weight and length of a child, reporting on child health and development care, participation in food support programs and demographic information. One quarter of the sample households are classified as food insecure. After adjusting for demographics, maternal BMI, and participation in the food support program, there was no significant relationship between food insecurity and childhood obesity, overweight, or stagnation except in 1 age group. Children in food insecure households are more likely to have a fair or bad risk to the health and development of many ages.

These findings are limited by the initial sample in cities and the reading of the caregiver's report. Furthermore, the researchers did not adjust to many comparisons. Nevertheless, the research is enhanced by its large national sample and the use of standardized tools and trained interviewers. For physicians, these findings highlight the importance of early identification of childhood food insecurity to promote health in the future.

Click to read the study published today in Pediatrics

Appropriate reading: Promoting food security for all children

In depth [cross-sectional study]: Researchers used data studies from Child HealthWatch, a 5-city network in the US that tracks economic hardship. Participants included 28 184 caregivers of children <4 years of age surveyed between 2009 and 2017 in emergency departments and primary care clinics. The children were weighed and measured. They were excluded if they were critically ill or had private insurance. Measures included food insecurity (assessed using the US Household Food Safety Monitoring Module), child weight and length, caregiver health and development, participation in food support programs, and demographic information. Multivariate logistic regression was used to model the links between food security and weight, health and development.

Insecure household foods make up 27% of the sample. After adjusting for demographics, maternal BMI and participation in the Food Assistance Program, the chances of obesity are significantly increased in children aged 25 to 36 months in home / child safety settings compared to those in food safety conditions (adjusted odds ratio [aOR] = 1.24; 95% confidence interval [CI] 1.01-1.52). There were no other significant links between food security and obesity, underweight or retention. The adjusted odds of good or poor health were increased in all age groups among children in food insecurity compared with those in nutritional conditions. Developmental risk factors are increased for children in several age groups in food insecure conditions.

Image: PD

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