Household Food Insecurity Across Childhood and Attempts at Weight Loss and Weight Gain in Early Adolescence: Findings From a Nationally Representative Study of U.S. Youth

Abstract Objectives To examine the relationships between food insecurity (FI) across childhood and attempts at weight loss and weight gain in early adolescence. Methods Data came from the Early Childhood Longitudinal Study, Kindergarten class of 1998–99, a nationally representative cohort of U.S. children. Parents reported household FI using the 18-item U.S. Household Food Security Survey Module when children were in kindergarten, grade 3, grade 5, and grade 8. Children self-reported weight change attempts in grade 8 (options: trying to lose weight, trying to gain weight, trying to stay the same weight, or not trying to do anything about weight). Of 7,558 children with survey weight data, 6,981 were included in the analytic sample after exclusions for missing variables. Poisson regression was used to examine associations between the total number of timepoints with FI (0, 1, 2, or 3–4 timepoints), as well as change in FI status from grade 5 to grade 8, with the prevalence of weight loss and weight gain attempts in grade 8. All models accounted for the complex sampling design and were adjusted for gender, age, race/ethnicity, socioeconomic status, and past history of FI (in models of recent change in FI only). Results Overall, 19.8% of children had FI during at least 1 timepoint, with 4.0% experiencing FI during 3–4 timepoints. Compared to experiencing FI at 0 timepoints, experiencing FI at 3–4 timepoints was associated with higher prevalence of weight loss attempts (Prevalence Ratio [PR] 1.24, 95% CI 1.04, 1.47), after adjusting for sociodemographic characteristics. Similarly, recently becoming food insecure (vs. remaining food secure) was associated with higher prevalence of weight loss attempts (PR 1.25, 95% CI 1.03, 1.52). Becoming food secure and remaining food insecure were not associated with attempting weight loss. Associations between FI during childhood and weight gain attempts were non-significant. Conclusions Experiencing FI at multiple timepoints across childhood and recently becoming food insecure are associated with greater likelihood of attempting to lose weight in early adolescence. Future research should examine the extent to which these associations are mediated by body mass index and how FI interventions might help prevent the harmful effects of weight loss attempts in this susceptible age group. Funding Sources N/A.