Association between kindergarten and first-grade food insecurity and weight status in U.S. children

• Published in: Nutrition (Burbank, Los Angeles County, Calif.) Vol. 51-52; pp. 1 - 5
• Main Authors: Lee, Arthur M., Scharf, Rebecca J., DeBoer, Mark D.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.07.2018; Elsevier Limited
• Subjects: Anthropometry; Body mass index; Body size; Childhood obesity; Children; Children & youth; Confidence intervals; Correlation analysis; Cybersecurity; Data processing; Early childhood; Education; Family income; Food; Food security; Households; Kindergarten; Longitudinal studies; Meals; Minority & ethnic groups; Obesity; Parents; Parents & parenting; Pediatrics; Public health; Questionnaires; Regression analysis; Regression models; Risk analysis; Risk factors; Socioeconomic factors; Statistical analysis; Statistics; United States > US; Early childhood; Pediatrics; Childhood obesity; Food security; Public health
• ISSN: 0899-9007; 1873-1244
• DOI: 10.1016/j.nut.2017.12.008

•Food insecurity affects 10% of U.S. households with kindergarteners, with the prevalence doubling in households earning <$65 000.•Food insecurity in first grade is a risk factor for increased body mass index z-score in both first and third grades, regardless of household income, parental education, or race/ethnicity.•Food insecurity in first grade is independently associated with increased obesity risk. This risk is attenuated by third grade.•Receiving Women, Infants, and Children benefits did not mitigate the risk for increased body mass index z-score and obesity among food-insecure first-graders. The aim of this study was to determine if food insecurity is an independent risk factor for obesity in U.S. children. We analyzed data from a nationally representative sample of children participating in the Early Childhood Longitudinal Study—Kindergarten Cohort 2011. Statistical analyses were performed to evaluate longitudinal associations between food security and body mass index (BMI) z-score. All regression models included race/ethnicity, household income, and parental education. Survey and anthropometric data was collected from teachers and parents of 8167 U.S. children entering kindergarten in fall 2010 with regular follow-up through third grade. Complete data regarding food security, socioeconomic assessment, and BMI z-score data were included for statistical analyses. All analyses were weighted to be nationally representative. Children with household food insecurity had increased obesity prevalence from kindergarten through grade 3; for example, at kindergarten, with food insecurity 16.4% (95% confidence interval [CI], 13.7–19) versus food secure 12.4% (95% CI, 11.3–13.6). Adjusted means analysis showed first-grade food insecurity was significantly correlated with increased BMI z-score in first through third grades; for example, at first grade, with food insecurity 0.6 (95% CI, 0.5–0.7) versus food secure 0.4 (95% CI, 0.4–0.5). Logistic regression showed first-grade food insecurity was correlated with increased risk for obesity in that grade (odds ratio 1.4; 95% CI, 1.1–2). Obesity is more prevalent among food-insecure children. First-grade food insecurity is an independent risk factor for longitudinal increases in BMI z-score. There are differences in the association between food insecurity and weight status between kindergarten and first grade.