Adult Food Insecurity is Associated with Heavier Weight Preferences among Black Women

Food insecurity is related to overweight/obesity among women. However, it is unknown whether food insecurity impacts individuals’ desired body composition, and whether this relationship differs by race/ethnicity similar to perceived ideal weight status. This study aims to evaluate whether food insecurity is related to elevated preferred weight status (e.g., overweight/obese versus normal weight) among black, white, and Hispanic women classified as overweight/obese. Four waves of NHANES data (2007–2014) were merged and yielded a total of 907 black, 1,271 white, and 1,005 Hispanic non-pregnant adult (age 20 to 59) women classified as overweight/obese. Participants self-reported their preferred weight status, adult-level food security, and demographic covariates. Covariate-adjusted logistic regression models stratified by race/ethnicity evaluated the role of food insecurity related to preferred weight status. Among black women, those who were food insecure were at 51% increased odds of preferring an overweight/obese weight status (OR: 1.51; 95% CI: 1.08 – 2.13; p = .02) relative to their food secure counterparts. Among white and Hispanic women, those who were food insecure had similar odds of preferring an overweight/obese weight status (White: OR: 1.07; 95% CI: 0.68 – 1.71; p = .76; Hispanic: OR: 0.95; 95% CI: 0.66 – 1.37; p = .77) relative to their food secure counterparts. Food insecurity results in the desire to be heavier among black women classified as overweight/obese. However, it does not impact white and Hispanic women classified as overweight/obese. Practitioners must consider weight preferences prior to providing obesity prevention information, particularly among food insecure black women

Household food insecurity status and Hispanic immigrant children’s body mass index and adiposity

Objectives: Despite the high prevalence rates of food insecurity and obesity among children of Hispanic immigrants, there has been a dearth of research on the direct relationship between food insecurity and obesity among this population. Further, prior research examining the association between food insecurity and body composition among children of Hispanic immigrants have not considered adiposity, specifically percent body fat (%BF) and waist circumference (WC), as outcome measurements. The following study contributes to the literature by examining the association between food insecurity and two adiposity measurements, %BF and WC, along with body mass index (BMI) among a sample of young Hispanic immigrant children. Methods: Cross-sectional survey and direct body composition assessments were collected among 49 low-income Hispanic immigrant children (mean age = 5.5. years) and their 44 mothers (mean age = 35.5 years) from two Houston-area community centers. Data were collected on household food security status using the 18-item USDA scale, demographic characteristics, and measured height, weight, body fat percentage, and waist circumference from children and mothers. Results: Sixty-five percent of children resided in a food insecure household, 31% of the children were obese in terms of %BF, and 24% were obese in terms of BMI. A greater percentage of food secure children were classified as obese in terms of %BF, BMI, and had an elevated waist circumference. A direct relationship was not observed between food insecurity and elevated waist circumference (OR = .08, p = .10); however, children living in food insecure households had 89% lower odds of having an elevated %BF (OR = 0.11, p \u3c .01), 93% lower odds of being obese (OR = 0.07, p \u3c .05), and 87% lower odds of being overweight/obese (OR = 0.13, p \u3c .05). Conclusions: In young children of Hispanic immigrants, food insecurity was related to healthier levels of %BF and BMI. Studies that track adiposity and weight status of children of Hispanic immigrants in relation to food insecurity over time are needed to further understand why food insecurity and obesity co-exist for some groups but not others

Relationship between Socioeconomic Status, Physical Activity, and Health Outcomes: National Health and Nutrition Examination Survey

According to the Social Determinants of Health, social factors such as education, income, and employment (i.e. factors that comprise socio-economic status, SES) impact adult health and associated health behaviors such as physical activity (PA). The purpose of this three-paper dissertation was to better understand the inter-relationship of SES, PA, sedentary behaviors (SB), and health (including metabolic syndrome and overweight/obesity) among a nationally representative sample of U.S. adults. Specifically, the three aims addressed the following 1) examined the relationship between three SES indicators: education, income, and employment status with non-leisure time physical activity (non-LTPA), 2) evaluated the relationship of occupational physical activity (OPA) and metabolic syndrome and its components, 3) assessed the role of LTPA and SB in the income-overweight/obesity relationship. To do this, all three aims utilized four waves of publicly available data from The National Health and Nutrition Examination Survey (NHANES) (2007– 2014), which included a total of 15,376 non-pregnant, non-older adults (aged 20-59 years). The sample was reduced to only include individuals who met the criteria and without missing data on the variables of interest for each aim (Aim 1: n=11,985, Aim 2: n= 3,253, Aim 3: n =10,348). Descriptive statistics, as well as weighted linear and logistic regression analyses were conducted using STATA version 15.0 statistical software (Aim 1 and 2). Structural equation modeling was conducted in Mplus version 8.3 (Aim 3). Survey procedures were used in all analyses to account for the NHANES sampling design. Aim 1: When examining the relationship between three SES indicators: education, income, and employment status with non-LTPA, findings indicated that only education and employment were related to non-LTPA. Having less than a high school education [OR = 1.44 (0.18), p < .01] and having a high school education [OR = 1.43 (0.12), p < .001] were associated with increased odds of meeting PA guidelines from non-LTPA, compared to a college degree. Part-time employment was associated with increased odds of meeting PA guidelines from non-LTPA [OR= 1.28 (0.12); p < .01], compared to full-time employment. Aim 2: When evaluating the relationship of OPA with metabolic syndrome and its components, findings suggest that OPA was not associated with metabolic syndrome, nor its components (p >.05). Further, the relationships did not differ between women and men (interaction term p >.05). Aim 3: When assessing the role of LTPA and SB in the income-overweight/obesity relationship, income indirectly influences overweight/obesity through its association with LTPA and SB. Greater income was negatively associated with overweight/obesity (Total effect: B=-0.046; 95%CI=-0.07,-0.02). Income indirectly influenced overweight/obesity through LPTA (Indirect effect: B=-0.005; 95%CI=-0.01,-0.003) and through SB (Indirect effect: B=0.008; 95%CI=0.005,0.01), but in opposing directions. The direct effect from income to overweight/obesity remained statistically significant (Direct Effect: B=-0.049; 95%C =-0.07;-0.02). LTPA partially accounted for the negative relationship between income and overweight/obesity; SB reduced the strength of the negative relationship between income and overweight/obesity. Aim 1 provides a comprehensive understanding of how SES is related to non-LTPA. Consequently, it raises awareness of the need to consider non-LTPA among low SES populations. Practitioners attempting to increase PA should consider these complexities and assess non-LTPA in addition to LTPA. Aim 2 indicated that there were no substantial associations between OPA and cardiovascular health indicators among a U.S. nationally representative cross-sectional sample. This contrasts findings from non-US-based samples which identified OPA as a risk factor for cardiovascular disease, especially among males (i.e. PA Health Paradox), Future prospective, longitudinal studies are needed to understand the long-term effects of OPA on the risk of experiencing metabolic syndrome among the U.S. population. Aim 3 suggests that targeted behavior approaches for weight management by income may be beneficial. Increasing LTPA among adults with lower income and decreasing SB among adults with higher income may provide some overweight/obesity protection. Taken together, these findings illustrate the complexities of the inter-relationships of SES, PA, SB, and health

Association between Food Insecurity and Diabetes: Differences by Sex and Socio-economic Status among Older Adults

The purpose of the study is to examine sex and socio-economic differences in the relationship between food insecurity and diabetes among low-income older adults.Health and Human Performance, Department ofHonors Colleg

Feasibility of Measuring Screen Time, Activity, and Context Among Families With Preschoolers: Intensive Longitudinal Pilot Study

BackgroundDigital media has made screen time more available across multiple contexts, but our understanding of the ways children and families use digital media has lagged behind the rapid adoption of this technology. ObjectiveThis study evaluated the feasibility of an intensive longitudinal data collection protocol to objectively measure digital media use, physical activity, sleep, sedentary behavior, and socioemotional context among caregiver-child dyads. This paper also describes preliminary convergent validity of ecological momentary assessment (EMA) measures and preliminary agreement between caregiver self-reported phone use and phone use collected from passive mobile sensing. MethodsCaregivers and their preschool-aged child (3-5 years) were recruited to complete a 30-day assessment protocol. Within 30-days, caregivers completed 7 days of EMA to measure child behavior problems and caregiver stress. Caregivers and children wore an Axivity AX3 (Newcastle Upon Tyne) accelerometer to assess physical activity, sedentary behavior, and sleep. Phone use was assessed via passive mobile sensing; we used Chronicle for Android users and screenshots of iOS screen time metrics for iOS users. Participants were invited to complete a second 14-day protocol approximately 3-12 months after their first assessment. We used Pearson correlations to examine preliminary convergent validity between validated questionnaire measures of caregiver psychological functioning, child behavior, and EMA items. Root mean square errors were computed to examine the preliminary agreement between caregiver self-reported phone use and objective phone use. ResultsOf 110 consenting participants, 105 completed all protocols (105/110, 95.5% retention rate). Compliance was defined a priori as completing ≥70%-75% of each protocol task. There were high compliance rates for passive mobile sensing for both Android (38/40, 95%) and iOS (64/65, 98%). EMA compliance was high (105/105, 100%), but fewer caregivers and children were compliant with accelerometry (62/99, 63% and 40/100, 40%, respectively). Average daily phone use was 383.4 (SD 157.0) minutes for Android users and 354.7 (SD 137.6) minutes for iOS users. There was poor agreement between objective and caregiver self-reported phone use; root mean square errors were 157.1 and 81.4 for Android and iOS users, respectively. Among families who completed the first assessment, 91 re-enrolled to complete the protocol a second time, approximately 7 months later (91/105, 86.7% retention rate). ConclusionsIt is feasible to collect intensive longitudinal data on objective digital media use simultaneously with accelerometry and EMA from an economically and racially diverse sample of families with preschool-aged children. The high compliance and retention of the study sample are encouraging signs that these methods of intensive longitudinal data collection can be completed in a longitudinal cohort study. The lack of agreement between self-reported and objectively measured mobile phone use highlights the need for additional research using objective methods to measure digital media use. International Registered Report Identifier (IRRID)RR2-3624

Measuring Microtemporal Processes Underlying Preschoolers’ Screen Use and Behavioral Health: Protocol for the Tots and Tech Study

BackgroundExcessive screen time is associated with poor health and behavioral outcomes in children. However, research on screen time use has been hindered by methodological limitations, including retrospective reports of usual screen time and lack of momentary etiologic processes occurring within each day. ObjectiveThis study is designed to assess the feasibility and utility of a comprehensive multibehavior protocol to measure the digital media use and screen time context among a racially and economically diverse sample of preschoolers and their families. This paper describes the recruitment, data collection, and analytical protocols for the Tots and Tech study. MethodsThe Tots and Tech study is a longitudinal, observational study of 100 dyads: caregivers and their preschool-age children (aged 3-5 years). Both caregivers and children will wear an Axivity AX3 accelerometer (Axivity Ltd) for 30 days to assess their physical activity, sedentary behavior, and sleep. Caregivers will complete ecological momentary assessments (EMAs) for 1 week to measure child behavioral problems, caregiver stress, and child screen time. ResultsThe Tots and Tech study was funded in March 2020. This study maintains rolling recruitment, with each dyad on their own assessment schedule, depending on the time of enrollment. Enrollment was scheduled to take place between September 2020 and May 2022. We aim to enroll 100 caregiver-child dyads. The Tots and Tech outcome paper is expected to be published in 2022. ConclusionsThe Tots and Tech study attempts to overcome previous methodological limitations by using objective measures of screen time, physical activity, sedentary behavior, and sleep behaviors with contextual factors measured by EMA. The results will be used to evaluate the feasibility and utility of a comprehensive multibehavior protocol using objective measures of mobile screen time and accelerometry in conjunction with EMA among caregiver-child dyads. Future observational and intervention studies will be able to use this study protocol to better measure screen time and its context. International Registered Report Identifier (IRRID)DERR1-10.2196/3624

ARE SPORTS THE CATALYST FOR MVPA BENEFITS IN OUT OF SCHOOL PROGRAMS? A MODERATION ANALYSIS IN ELEMENTARY-AGED CHILDREN

BACKGROUND: The structured days hypothesis (SDH) suggests when children are in structured environments, they have healthier movement behaviors, including more moderate-to-vigorous physical activity (MVPA). Out of school programs (OSPs), such as sports, are a popular form of structured environments, and there is evidence that participation in these OSPs are associated with higher MVPA in elementary-aged children; however, it is not clear if sports are the primary driver of the association between OSPs and MVPA. Therefore, the purpose of this study was to examine whether attending sports programs, specifically, moderates the effect between OSPs and MVPA in elementary-aged children. METHODS Children (N=685; 48.7% female; 52.7% White; K-5th grade) participated in a 14-day observational protocol as part of a prospective cohort study in Spring 2022. Each night, parents completed texted surveys about their child’s participation in OSPs, including timing and type. Children wore an Actigraph GT9X accelerometer on their non-dominant wrist to measure MVPA. Accelerometer data were processed using GGIR (v 2.8-2). Linear mixed-effects models predicted day-level MVPA from time spent in OSPs. Moderation effects were examined with sports (coded as sports vs. no sports) by OSP time interaction. Only weekdays were included for this analysis. Sex, income, grade, time spent in school, and accelerometer non-wear time were included as covariates. RESULTS: Of the 421 children that attended OSPs, 53% attended sports programs, 34% attended after-school programs, and 13% attended other programs (art, dance, etc.). On average, on days when children went to an OSP, they attended for 117.2±55.0 minutes, specifically, children spent 96.8±53.7 minutes at sports, 156.2±54.7 minutes at after-school programs, and 103.0±57.6 minutes in other programs. Mixed-effects models suggested that time spent in OSPs on a given day were linked with higher MVPA for that day, such that children engaged in 0.1 more minutes of MVPA for every additional minute attending OSPs (95CI=0.1, 0.2). Attending sports programs specifically was not associated with additional MVPA beyond participating in other OSPs (B=-0.1±0.1; 95CI=-0.2, 0.0). CONCLUSION: On days when children spend more time in OSPs, they have higher MVPA, but there were not additional MVPA benefits when children were attending sports versus other OSPs. Our data supports the SDH suggesting that filling children’s time with structure, despite what type of structure it is, is associated with healthier movement behaviors