Academic journal article Childhood Obesity

The Relationship between Dietary Patterns, Body Mass Index Percentile, and Household Food Security in Young Urban Children

Academic journal article Childhood Obesity

The Relationship between Dietary Patterns, Body Mass Index Percentile, and Household Food Security in Young Urban Children

Article excerpt

[Author Affiliation]

Christine M. Trapp. 1 Division of Endocrinology, Connecticut Children's Medical Center, Hartford, CT. 2 Department of Pediatrics, University of Connecticut Health Center, Farmington, CT.

Georgine Burke. 2 Department of Pediatrics, University of Connecticut Health Center, Farmington, CT. 3 Division of Research, Connecticut Children's Medical Center, Hartford, CT.

Amy A. Gorin. 4 Department of Psychology, University of Connecticut, Storrs, CT.

James F. Wiley. 5 Children's Center for Community Research, Connecticut Children's Medical Center, Hartford, CT.

Dominica Hernandez. 4 Department of Psychology, University of Connecticut, Storrs, CT.

Rebecca E. Crowell. 6 Department of Research, Saint Francis Hospital and Medical Center, Hartford, CT.

Autherene Grant. 5 Children's Center for Community Research, Connecticut Children's Medical Center, Hartford, CT.

Annamarie Beaulieu. 7 Department of Academic Administration, Connecticut Children's Medical Center, Hartford, CT.

Michelle M. Cloutier. 2 Department of Pediatrics, University of Connecticut Health Center, Farmington, CT. 5 Children's Center for Community Research, Connecticut Children's Medical Center, Hartford, CT.

Address correspondence to: Christine M. Trapp, MD, Division of Endocrinology, Connecticut Children's Medical Center, 282 Washington Street, Hartford, CT 06106, E-mail: ctrapp@connecticutchildrens.org

Introduction

Seventeen percent of children and adolescents in the United States between the ages of 2 and 19 years are obese, with disproportionately higher rates in Hispanic and non-Hispanic black children and adolescents.1 Though the etiology of these racial/ethnic disparities in obesity rates is not entirely understood and is likely multifactorial, differences in built environment, genetics, and maternal factors may account for the higher rates observed.2 Among low-income children, nearly one third of children ages 2-4 years are overweight or obese.3 Childhood obesity is associated with cardiovascular dysfunction and other comorbidities that may have a significant impact on future health.4,5

Many risk factors for obesity in young children from low-income households have been suggested, including food insecurity.6 Low-income households experience high rates of food insecurity, which is defined as "the limited or uncertain availability of nutritionally adequate and safe foods and limited or uncertain ability to acquire acceptable foods in a socially acceptable way."7 The relationship between household food insecurity and overweight has been consistently observed in adults, and especially women, but the data in children are conflicting.8-14 Gundersen and colleagues did not find an association between household food insecurity and childhood obesity using multiple measures of obesity.15 However, a recent longitudinal study in low-income children 2-5 years of age found that persistent household food insecurity was associated with 22% greater odds of child obesity.16

Few studies of weight status and household food security have examined dietary intake patterns in children. Several studies have demonstrated an association between household food insecurity and altered dietary patterns, particularly decreased vegetable consumption, but these studies either did not examine child BMI or they found no difference in child BMI percentile between food secure and insecure households.17-20 Only one study examined food insecurity, diet, and weight status in children and found that food-insecure children were more likely to be overweight and have greater intake of high-fat cereals, salty foods, and high-energy-density sweets, as compared to food-secure children. …

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