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Application of Noninferiority Tests to Examine the Food Insecurity-Obesity Relationship in Children

Taren M Swindle1, Shalese Fitzgerald1, Lorraine McKelvey1

  • 1Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham St, #530, Little Rock, AR 72205-7199; United States of America.

Journal of Hunger & Environmental Nutrition
|March 26, 2019
PubMed

Insights

Food insecurity is linked to higher odds of overweight in preschool children. However, this association reverses when parents have education beyond high school, suggesting complex interactions.

Area of Science:

  • Pediatric Nutrition
  • Public Health
  • Statistical Methods

Background:

  • Childhood obesity is a significant public health concern.
  • Food security status is a potential determinant of child weight.
  • Existing research often uses traditional statistical methods to explore this relationship.

Purpose of the Study:

  • To apply non-inferiority testing to evaluate the association between child weight and food security status.
  • To examine this relationship in a diverse urban, state-funded preschool population.
  • To explore potential moderating effects of parental education.

Main Methods:

  • Non-inferiority testing was employed to analyze data from 808 children aged 3-5 years.
  • The study compared overweight prevalence between Food Insecure (FI) and Food Secure (FS) groups.
  • Subgroup analyses were conducted for gender, race, family conflict, and parental education level.

Main Results:

  • Food insecurity was associated with higher odds of overweight (OR=1.127, P=.004) in the overall sample.
  • This association remained consistent across gender, race, and family conflict subgroups.
  • A reversal was observed in children whose parents had education beyond high school (FI odds of overweight < FS odds, OR=.663).

Conclusions:

  • Non-inferiority testing offers a valuable alternative approach for analyzing food security and child weight associations.
  • Parental education level may modify the relationship between food insecurity and childhood overweight.
  • Further research is warranted to understand these complex interactions in child health outcomes.

Keywords:
ChildrenFood InsecurityObesity

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