Food Insecurity Predicts Magnitude of Early BMI Change in a Pediatric Weight Management Intervention
Miranda L Frank1, Christina X Korth1, Clarissa V Shields1
1Department of Psychological Sciences, Kent State University, Kent, OH.
Insights
Food insecurity affects nearly 30% of children in weight management programs. Greater food insecurity is linked to a smaller decrease in body mass index (BMI) percentile during early treatment.
Area of Science:
- Pediatric Endocrinology
- Public Health Nutrition
- Behavioral Medicine
Background:
- Food insecurity is a significant public health issue impacting child health outcomes.
- Children with overweight/obesity often face complex socioeconomic challenges, including food insecurity.
- Understanding the interplay between food insecurity and weight management is crucial for effective interventions.
Purpose of the Study:
- To determine the prevalence of food insecurity in children undergoing weight management.
- To investigate if food insecurity predicts changes in body mass index percentile (%BMIp95) during early treatment.
Main Methods:
- A cohort of 69 children (ages 3-18) and their guardians participated in a hospital-based weight management program.
- Food security status was assessed using the US Household Food Security Survey Module.
- Child height and weight were measured at baseline and 3 months to calculate %BMIp95 change.
Main Results:
- Food insecurity was reported by 29.0% of participating families.
- Food insecurity significantly predicted %BMIp95 change, accounting for 11.4% of the variance (p=0.01).
- Children with higher food insecurity showed a smaller reduction in %BMIp95, indicating a smaller magnitude of BMI decrease.
Conclusions:
- A substantial proportion of families in pediatric weight management programs experience food insecurity.
- Food insecurity, beyond household income, may uniquely influence early treatment response in pediatric obesity.
- Further research is needed to explore the complex relationships between food insecurity, income, BMI, and race in pediatric weight management.
Objective:
The aim of this study was to estimate the prevalence of food insecurity among children with overweight/obesity presenting for weight management treatment and examine whether food insecurity predicts early change in body mass index (BMI), expressed as a percentage of the 95th percentile (%BMIp95).
Method:
Children (N = 69; ages 3-18 years) presenting to a hospital-based pediatric weight management intervention and 1 parent/guardian per child (N = 69) were included. At the first appointment, parents/guardians completed the US Household Food Security Survey Module: Six-item Short Form and a demographics questionnaire. Height and weight of the children were measured at the first and third appointments to calculate %BMIp95.
Results:
Among participating families, 29.0% reported experiencing food insecurity. Controlling for the ratio of income to poverty, 11.4% of the variance in %BMIp95 change from the first to third appointments was accounted for by food insecurity, ▵F (1, 66) = 8.46, p = 0.01. Children with greater food insecurity demonstrated a smaller magnitude of %BMIp95 decrease, representing a small-to-medium effect size within the context of the regression model (f2 = 0.13).
Conclusion:
A high proportion of families with children receiving weight management treatment reported experiencing food insecurity in comparison with US households with children. There may be unique characteristics of food insecurity, as opposed to household income alone, that explain the smaller magnitude of BMI decrease observed early in treatment. Future research should explore complex associations among food insecurity, income, BMI, and race over time.
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