Household food insecurity and its association with childhood overweight and obesity

Abstract Background. The objective was to estimate the prevalence of household food insecurity (HFI), associated sociodemographic factors and their relationship with childhood overweight and obesity.Methods. The data come from 1,938 children aged 2 to 14 years who participated in the Malnutrition Study of the Community of Madrid. Weight and height were obtained through physical examination. Body mass index was calculated as weight in kilograms divided by height in meters squared, and for the definition of overweight and obesity, the criteria of the World Health Organization (WHO) were used. The parents of the participants answered a structured questionnaire about the diet, lifestyle (physical activity and use of TV and computer screens) and food insecurity. The diet quality was assessed by the Healthy Eating Index (HEI) in Spain. The HFI was evaluated with the Household Food Insecurity Access (HFIAS) survey. Odds Ratios (ORs) and Relative Risk Ratios (RRRs) were estimated using logistic regression models adjusted for confounding variables.Results. The prevalence of HFI was 7.7% (95% CI: 6.6-9.0). The prevalence was lower in children 2 to 4 years (5.7%, 95% CI: 4.0-8.1) and higher in households with low family purchasing power (37.3%; OR: 8.99 (95% CI: 5.5-14.6). Children who were at HFI had a lower diet quality and spent more time in front of screens, and had a higher prevalence of overweight (33.1%) and obesity (28.4%) than those who lived in household food security (HFS) (21.0% and 11.5%, respectively). Compared with children in HFS, those who lived in HFI had RRRs of overweight of 2.41 (95% CI: 1.5-4.0) and 1.99 (95% CI: 1.2-3.4) of obesity.Conclusions. HFI reaches a high prevalence among children, especially in households with low family purchasing power. HFI probably is associated with lower diet quality and an increase in the prevalence of childhood overweight and obesity. Our results suggest the need to detect early, in paediatric services, at-risk households to avoid this double burden of child malnutrition.