Public Health and Primary CareOriginal Article

Food Insecurity and Its Association With Central Obesity and Other Markers of Metabolic Syndrome Among Persons Aged 12 to 18 Years in the United States

David H. Holben, PhD, RDN, LD, and Christopher A. Taylor, PhD, RDN, LD
Notes and Affiliations
Notes and Affiliations

Accepted: April 13, 2015

Published: September 1, 2015

J Osteopath Med; 115(9): 536-543

Context: Food insecurity is a preventable health threat and may precipitate central obesity and metabolic syndrome in children and adolescents in the United States.

Objectives: To examine (1) health by household food security status; and (2) differences and prevalence of central obesity among persons aged 12 to 18 years in the United States.

Methods: The National Health and Nutrition Examination Survey was administered to a cross-sectional sample of persons aged 12 to 18 years in 1999 to 2006. Controlling for age, race/ethnicity, and sex differences in mean obesity and chronic disease factors across levels of food insecurity (analysis of covariance [Bonferroni post hoc] and ORs [logistic regression analyses]) were examined, as were differences in the rates of risk factors (χ2 statistics).

Results: A total of 7435 participants were analyzed. Those from marginally food secure (n=751) and low–food secure (n=1206) (population size estimate, 26,714,182) households were significantly more likely than their high–food secure counterparts (n=4831) to be overweight (P=.036) (OR, 1.44), and those from marginally food secure households were 1.3-times more likely to be obese (P=.036). Nearly 25% of respondents from marginally food secure, low–food secure, and very low–food secure (n=647) households reported central obesity (P=.002), which was 1.4 to 1.5 times more likely than those from high–food secure households. Participants from high–food secure households had significantly higher mean high-density lipoprotein values (P=.019). Risk factors indicative of metabolic syndrome were present in 3.1%.

Conclusions: Household food insecurity was associated with an increased likelihood of being overweight and having central obesity. Limitations included the use of cross-sectional data and some self-reported data and the inability to control for all moderating variables in obesity and overall health status.

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