December 2012 Summary

A Longitudinal Study of Food Insecurity on Obesity in Preschool Children

                It is important to identify factors associated with childhood obesity because children who gain weight rapidly during their first few years of life are at increased obesity risk later in their lives. Results of this study suggest that food insecurity without hunger is related to child obesity but that the association depends on maternal weight status. This vulnerable group, overweight/obese mothers in a food insecure household and their children, should be reached for early intervention to prevent overweight and obesity in their children’s lives.

                However, this relationship appears to be complex. Authors also mention that some evidence suggests that food insecurity effects obesity risk indirectly through parenting and infant feeding practices. It has been observed that less supportive parenting and infant feeding practices are found in households with food insecurity. Also, there is evidence that feeding behaviors of the mothers can affect children differently, depending on mother weight-status. One study reported that overweight mothers’ restriction of food intake by their 5 year-old daughters increased the child’s eating in the absence of hunger at age 9. The same effect was not found with normal-weight mothers and their daughters.

Women living in food insecure households may be limiting their own intake (in different ways) in order to provide their children with food (quality may be poor). This can lead to children’s increased consumption of lower-quality foods that are typically higher in refined grains, fat, and sugar, and are less satiating and more likely to lead to weight gain.

Question 1: Give an example of how food insecurity may lead to obesity in general. 

• Molly explained how limited resources (healthcare and healthy, affordable food – Angela mentions food deserts), physical activity, and stress can contribute. Amy elaborated that limited physical activity can lead to excess TV and video game time.
• Alana and Angela added that those who are food insecure commonly purchase foods at convenience stores. Similarly, Kelsey and Joci included how fast-food $1 menus catch the attention of many looking to stretch their dollar and that fruits and vegetables aren’t seen as necessary. Taylor explained how purchasing single-serving quantities at these locations can contribute. Amy elaborated that these foods are not nutritionally dense and high in kcal and fat.
• Nate, Angela, and Kelsey included how these foods may lead to people feeling tired and being sedentary or eating more, further contributing to the obesity problem.
• Amy also included an experience she witnessed of how food insecurity can affect feeding practices by leading to bingeing cycles. Molly stated these experiences can also be hidden among college students and middle class citizens.
• Erin explained that habits are formed early in life affecting children later in life when they make their own food/meal choices.
• Kelsey and Erin agree that education and practice cooking healthy meals may be lacking in those who are in food insecure households and see this as an area of potential intervention.

Question 2: Explain, in your opinion, why household food insecurity without hunger would be more attributed to obesity in children than either food insecurity with hunger or food security.

• Molly and Erin mention eating without hunger when food is available, leading to individuals not learning to understand body cues.
• Alana, Erin, and Nate say the quality of food tends to exclude protein and fiber, limiting satiety and see this as an area of potential educational intervention.
• Nate adds that food security is more likely to lead to individuals eating until they are full and then stopping, with no fear of when their next meal is coming. He and Kelsey say it may also be correlated with more education.
• Amy and Kelsey mention limited education in their explanation. Kelsey and Taylor bring up the misperception that healthy food and a healthy lifestyle is expensive.
• Molly also mentions some of the biochemistry of different feeding practices such as increased abdominal fat storage.

Question 3: The authors reference that 41% of low-income households experienced food insecurity in 2010. What are some examples of how RDs could help prevent low-income households from suffering the consequences of food insecurity (at any level)?

• Molly mentioned encouraging communities to make donations when they can and also mentioned examples of community advocacy by RDs.
• Almost everyone mentioned knowing local resources and many provided specific examples. This is such valuable information for those in immediate need.
• Molly, Nate, Amy, Erin, and Joci agree that if counseling someone in a household of low food security that education is important. Classes may include basic food preparation, how home preparation is cheaper than buying prepared food, stretching your dollar, making food last, and a targeted grocery store tours.
• Alana and Molly agree that if counseling individuals in a food insecure household, it is important to recognize it is a sensitive topic for parents specifically and to not be judgmental by practicing empathy.
• Alana and Nate added that being supportive, encouraging, empathetic, and patient is important to keep their interest and trust.
• Kelsey and Taylor concluded that getting involved at places where food insecure families will be (food pantries, soup kitchens, backpack programs, etc.) is the most important thing because many of these families will never end up in a counseling session with an RD. They also emphasized being personally involved and creating solutions in communities. Taylor recommends being direct and creating solutions for families instead of showing them their options.