21 research outputs found
Dyslipidemia and Food Security in Low-Income US Adolescents: National Health and Nutrition Examination Survey, 2003-2010.
INTRODUCTION: Low levels of food security are associated with dyslipidemia and chronic disease in adults, particularly in women. There is a gap in knowledge about the relationship between food security among youth and dyslipidemia and chronic disease. We investigated the relationship between food security status and dyslipidemia among low-income adolescents.
METHODS: We analyzed data from adolescents aged 12 to 18 years (N = 1,072) from households with incomes at or below 200% of the federal poverty level from the National Health and Nutrition Examination Survey (NHANES) 2003-2010. We used logistic regression to examine the relationship between household food security status and the odds of having abnormalities with fasting total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), serum triglycerides (TGs), high-density lipoprotein cholesterol (HDL-C), TG/HDL-C ratio, and apolipoprotein B (Apo B). Models included age, sex, race/ethnicity, smoking status, partnered status in the household, and maternal education, with additional adjustment for adiposity.
RESULTS: Household food security status was not associated with elevated TC or LDL-C. Adolescents with marginal food security were more likely than food-secure peers to have elevated TGs (odds ratio [OR] = 1.86; 95% confidence interval [CI], 1.14-3.05), TG/HDL-C ratio (OR = 1.74; 95% CI, 1.11-2.82), and Apo B (OR = 1.98; 95% CI, 1.17-3.36). Female adolescents with marginal food security had greater odds than male adolescents of having low HDL-C (OR = 2.69; 95% CI, 1.14-6.37). No elevated odds of dyslipidemia were found for adolescents with low or very low food security. Adjustment for adiposity did not attenuate estimates.
CONCLUSION: In this nationally representative sample, low-income adolescents living in households with marginal food security had increased odds of having a pattern consistent with atherogenic dyslipidemia, which represents a cardiometabolic burden above their risk from adiposity alone
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Food Insecurity and Pediatric Obesity: a Double Whammy in the Era of COVID-19.
Purpose of reviewThis review examines the current evidence about the ways in which food insecurity relates to obesity in children and adolescents, examining diet and diet-related behaviors, and taking into consideration the role of stress.Recent findingsWhile living with food insecurity impacts stress and diet-related behaviors in children and adolescents, it is not clear whether food insecurity is associated with obesity above and beyond the influence of poverty. However, strategies to mitigate food insecurity and obesity are inherently connected, and recent examples from clinical practice (e.g., screening for food insecurity among patients) and advocacy (e.g., policy considerations regarding federal food programs such as the Supplemental Nutrition Assistance Program, or SNAP) are discussed. Food insecurity and obesity coexist in low-income children and adolescents in the USA. The COVID-19 pandemic exerts disproportionate burden on low-income children and families, magnifying their vulnerability to both food insecurity and pediatric obesity
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Disordered eating behaviours and food insecurity: A qualitative study about children with obesity in low-income households
BackgroundWhile there is information in the literature describing the poor nutritional intake of food-insecure youth, eating behaviours among food-insecure children - particularly, obese children are less well-described. We conducted focus groups with family members of low-income children who were initiating care in a paediatric obesity clinic. Food hiding emerged as a theme, and generated the motivation for this analysis.MethodsBetween April 2012 and December 2013, a total of 7 focus groups were conducted (4 food-insecure groups and 3 food-secure). Based on recruitment from 37 index patients, the focus groups were attended by a total of 47 participants. Participant responses about eating behaviours were evaluated using a combination of inductive codes derived from the data and deductive codes informed by criteria for diagnosis of disordered eating.ResultsWhile participants from food-secure and food-insecure households all had anecdotes about their children overeating, respondents in two of the food-insecure groups described episodes that resemble binge eating. The topic of hiding food emerged in the food-insecure groups, though was not endorsed in the food-secure groups despite probing. Night-time eating arose spontaneously in two of the food-insecure groups, but not in the food-secure groups.ConclusionThis study highlights the presence of food hiding, binge eating, and night-time eating in food-insecure children with obesity. These factors would further compound their health burden, and the relationship between disordered eating and food insecurity in children with obesity warrants further study
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Whole Grain Intake and Impaired Fasting Glucose in Adolescents, National Health and Nutrition Examination Survey, 2005-2014.
IntroductionLarge prospective cohort studies show a lower risk of developing type 2 diabetes among adults with higher whole grain consumption. Less is known about the relationship between whole grain consumption and precursors for diabetes risk in adolescents. We examined whether intake of whole grains was associated with impaired fasting glucose (IFG) in adolescents.MethodsWe analyzed data on dietary intake from an average of two 24-hour diet recalls from fasting, nondiabetic adolescents aged 12-18 years (N = 2,286) across 5 cycles of the National Health and Nutrition Examination Survey (NHANES 2005-2014). We used logistic regression to calculate the odds of having IFG (100-125 mg/dL) with respect to servings of whole and refined grains, as well as percentage of whole grains, adjusting for sex, age, race/ethnicity, annual household income, obesity, total energy, and diet quality.ResultsIFG was present in 17% of participants. After adjusting for covariates, number of servings per day of whole grains was significantly associated with lower odds of IFG, but there was no relationship between IFG and servings of refined grains or percentage of whole grains. Consuming at least 1 ounce-equivalent serving (16 g) of whole grains daily, compared with consuming no whole grains, was associated with a 40% reduction in the adjusted odds of having IFG (adjusted odds ratio = 0.60; 95% CI, 0.38-0.93).ConclusionAnalysis of 10 years of national cross-sectional data suggests that US adolescents whose daily diets consist of a minimum threshold amount of whole grains may be less likely to have IFG, a finding that has implications for diabetes prevention in adolescents
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Biobehavioral Factors That Shape Nutrition in Low-Income Populations A Narrative Review
Although evidence exists for an association between income level and diet quality, a causal relationship has not been established. A number of studies found that the price of nutritious food and the time cost to prepare foods are economically driven reasons for this relationship. However, in addition to economic constraints, low-income individuals and families face a number of additional challenges linked with food choice, eating behaviors, and diet-related chronic conditions that contribute to diet quality and health. Low-income individuals have a higher burden of employment-, food-, and housing-related insecurity that threaten the livelihood of their household. Poverty and exposure to these insecurities are hypothesized to activate biobehavioral and psychological mechanisms-endocrine, immune, and neurologic systems-that influence food choice and consumption. Examples of biobehavioral and psychological factors that influence diet are stress, poor sleep, and diminished cognitive capacity. High levels of stress, poor sleep, and cognitive overload compound the challenges of economic constraints, creating a mentality of scarcity that leads to poor diet quality