Article

Growing up poor: Long-term implications for eating patterns and body weight

Authors:
To read the full-text of this research, you can request a copy directly from the authors.

Abstract

This study aimed to understand how poverty-associated food deprivation in childhood contributes to the well-known relationship between low socioeconomic status (SES) in childhood and obesity in the adult years. Thirty low-income, rural women with at least one child were followed for over three years with annual semi-structured interviews collecting quantitative and qualitative data. For the quantitative portion, the measures of interest were body mass index (BMI), food insecurity, eating patterns, and SES. For the qualitative portion, text from the interviews was analyzed using the constant comparative method. Growing up in a poor household was associated with increased risk of overweight and obesity in adulthood. Experiences of poverty-associated food deprivation in childhood appeared to super-motivate some women to actively avoid food insecurity in adulthood. It also influenced the women's current food preferences. Tremendous excitement accompanied the availability of food after periods of deprivation in both the women and their children. Some women had used food to meet emotional needs in childhood and overeating had become a generalized response to negative emotional states in the adult years. Food deprivation in childhood and associated attitudes and behaviors towards food are one possible mechanism for explaining the association between childhood poverty and adult obesity.

No full-text available

Request Full-text Paper PDF

To read the full-text of this research,
you can request a copy directly from the authors.

... Mothers' expectations, attitudes, and behaviors toward food were found to be strongly influenced by their childhood food-related experiences (Olson, Bove, & Miller, 2007;Sano, Gibbs, & Vaughn, 2013). For example, Olson et al. (2007) reported that women who had experienced food deprivation during their childhood were more likely to use food to meet their emotional needs, developed tendencies to overeat when they experienced negative emotions, were super-motivated to actively avoid food insecurity, and showed tremendous excitement toward food after periods of deprivation. ...
... Mothers' expectations, attitudes, and behaviors toward food were found to be strongly influenced by their childhood food-related experiences (Olson, Bove, & Miller, 2007;Sano, Gibbs, & Vaughn, 2013). For example, Olson et al. (2007) reported that women who had experienced food deprivation during their childhood were more likely to use food to meet their emotional needs, developed tendencies to overeat when they experienced negative emotions, were super-motivated to actively avoid food insecurity, and showed tremendous excitement toward food after periods of deprivation. Several studies have also documented that food insecurity and/or deprivation in childhood and adulthood resulted in mothers' disordered eating patterns such as food binges (Bove & Olson, 2006;Olson & Bove, 2005;Olson et al., 2007;Mammen, Bauer, & Richards, 2009). ...
... For example, Olson et al. (2007) reported that women who had experienced food deprivation during their childhood were more likely to use food to meet their emotional needs, developed tendencies to overeat when they experienced negative emotions, were super-motivated to actively avoid food insecurity, and showed tremendous excitement toward food after periods of deprivation. Several studies have also documented that food insecurity and/or deprivation in childhood and adulthood resulted in mothers' disordered eating patterns such as food binges (Bove & Olson, 2006;Olson & Bove, 2005;Olson et al., 2007;Mammen, Bauer, & Richards, 2009). These patterns may be one factor contributing to the prevalence of overweightness and obesity among the low-income population. ...
... Mothers' expectations, attitudes, and behaviors toward food were found to be strongly influenced by their childhood food-related experiences (Olson, Bove, & Miller, 2007;Sano, Gibbs, & Vaughn, 2013). For example, Olson et al. (2007) reported that women who had experienced food deprivation during their childhood were more likely to use food to meet their emotional needs, developed tendencies to overeat when they experienced negative emotions, were super-motivated to actively avoid food insecurity, and showed tremendous excitement toward food after periods of deprivation. ...
... Mothers' expectations, attitudes, and behaviors toward food were found to be strongly influenced by their childhood food-related experiences (Olson, Bove, & Miller, 2007;Sano, Gibbs, & Vaughn, 2013). For example, Olson et al. (2007) reported that women who had experienced food deprivation during their childhood were more likely to use food to meet their emotional needs, developed tendencies to overeat when they experienced negative emotions, were super-motivated to actively avoid food insecurity, and showed tremendous excitement toward food after periods of deprivation. Several studies have also documented that food insecurity and/or deprivation in childhood and adulthood resulted in mothers' disordered eating patterns such as food binges (Bove & Olson, 2006;Olson & Bove, 2005;Olson et al., 2007;Mammen, Bauer, & Richards, 2009). ...
... For example, Olson et al. (2007) reported that women who had experienced food deprivation during their childhood were more likely to use food to meet their emotional needs, developed tendencies to overeat when they experienced negative emotions, were super-motivated to actively avoid food insecurity, and showed tremendous excitement toward food after periods of deprivation. Several studies have also documented that food insecurity and/or deprivation in childhood and adulthood resulted in mothers' disordered eating patterns such as food binges (Bove & Olson, 2006;Olson & Bove, 2005;Olson et al., 2007;Mammen, Bauer, & Richards, 2009). These patterns may be one factor contributing to the prevalence of overweightness and obesity among the low-income population. ...
... Mothers' expectations, attitudes, and behaviors toward food were found to be strongly influenced by their childhood food-related experiences (Olson, Bove, & Miller, 2007;Sano, Gibbs, & Vaughn, 2013). For example, Olson et al. (2007) reported that women who had experienced food deprivation during their childhood were more likely to use food to meet their emotional needs, developed tendencies to overeat when they experienced negative emotions, were super-motivated to actively avoid food insecurity, and showed tremendous excitement toward food after periods of deprivation. ...
... Mothers' expectations, attitudes, and behaviors toward food were found to be strongly influenced by their childhood food-related experiences (Olson, Bove, & Miller, 2007;Sano, Gibbs, & Vaughn, 2013). For example, Olson et al. (2007) reported that women who had experienced food deprivation during their childhood were more likely to use food to meet their emotional needs, developed tendencies to overeat when they experienced negative emotions, were super-motivated to actively avoid food insecurity, and showed tremendous excitement toward food after periods of deprivation. Several studies have also documented that food insecurity and/or deprivation in childhood and adulthood resulted in mothers' disordered eating patterns such as food binges (Bove & Olson, 2006;Olson & Bove, 2005;Olson et al., 2007;Mammen, Bauer, & Richards, 2009). ...
... For example, Olson et al. (2007) reported that women who had experienced food deprivation during their childhood were more likely to use food to meet their emotional needs, developed tendencies to overeat when they experienced negative emotions, were super-motivated to actively avoid food insecurity, and showed tremendous excitement toward food after periods of deprivation. Several studies have also documented that food insecurity and/or deprivation in childhood and adulthood resulted in mothers' disordered eating patterns such as food binges (Bove & Olson, 2006;Olson & Bove, 2005;Olson et al., 2007;Mammen, Bauer, & Richards, 2009). These patterns may be one factor contributing to the prevalence of overweightness and obesity among the low-income population. ...
... Food insecurity (FI), a lack of reliable or limited access to sufficient food for an active and healthy life, is a national public health problem. 1 FI has been associated with childhood obesity; however, previous research has shown positive, negative and null associations. 2 FI and obesity are both linked to social and economic disadvantage, 3,4 and FI has been implicated in the inverse association between income and obesity, 4 though results regarding FI and child weight status are mixed. 5 The mechanisms by which FI may influence weight gain in children are poorly understood. ...
... Food insecurity (FI), a lack of reliable or limited access to sufficient food for an active and healthy life, is a national public health problem. 1 FI has been associated with childhood obesity; however, previous research has shown positive, negative and null associations. 2 FI and obesity are both linked to social and economic disadvantage, 3,4 and FI has been implicated in the inverse association between income and obesity, 4 though results regarding FI and child weight status are mixed. 5 The mechanisms by which FI may influence weight gain in children are poorly understood. ...
... Qualitative research with parents and children has linked periods of limited food availability to immense anticipation about food in addition to excitement and overeating when food becomes available again. 4 These experiences may lead to more general patterns of overeating and eating for reasons besides hunger (e.g., the presence of food, emotional comfort). ...
Article
Background Food insecurity (FI) may increase the odds for childhood obesity, yet little is known about the mechanism explaining this relationship. Parents experience greater psychosocial stress in the context of FI. In these environments, children from FI households may exhibit different appetitive behaviours. Objectives To examine associations between FI and appetitive behaviours in children (3–5 years) and to explore whether social, emotional and structural properties of the home environment moderate this relationship. Methods In a low-income sample of 504 parent–child dyads, parents completed the household food security module and the Children's Eating Behavior Questionnaire. A subsample (n = 361) self-reported perceived stress, depressive symptoms, household chaos and family functioning. Children were categorized as food secure, household FI and child FI. Results Food responsiveness (LSmeans ± SE; child FI: 2.56 ± 0.13; food secure: 2.31 ± 0.10, p < 0.05) and emotional overeating (LSmeans ± SE; child FI: 1.69 ± 0.10; food secure: 1.48 ± 0.08, p < 0.05) were higher among children in the child FI group compared to the food secure group. Child FI was only associated with higher food responsiveness among children of parents reporting high levels of perceived stress (p = 0.04) and low levels of family functioning (p = 0.01). There were no differences in food responsiveness by food security status at mean or low levels of perceived stress or at mean or high levels of family functioning (p > 0.05). Conclusions Child FI may contribute to obesity risk through differences in appetitive behaviours. For low-income families, stress management and improving family dynamics may be important factors for interventions designed to improve children's appetitive behaviours.
... Experiences of chronic food insecurity can influence how children learn to acquire and prepare food and may impact family beliefs and values [82]. Through experiences of childhood food insecurity, children learn food management strategies that prepare them to be able to provide food for their families as an adult [83,84].In food insecure households, a "healthful" diet may be based on having a sufficient quantity of food rather than being focused on the nutritional quality of the food provided [65]. These experiences and values are likely to have long-term psychosocial impacts that influence parent feeding behaviors. ...
... These experiences and values are likely to have long-term psychosocial impacts that influence parent feeding behaviors. For example, parents who experienced food insecurity as a child report being highly motivated to prioritize feeding their children over all other necessities [83]. ...
... Many low-income parents describe wanting to give children what they wished they had as a child and to protect their children from feelings of deprivation [88,89]. In particular, parents who experienced early food insecurity report finding it difficult to say no to children's requests for food, especially when it is plentiful at the beginning of the month, and often the food requested is not of high nutritional quality [83,88]. Previous research has shown that consumption of sweets and soda is higher among children of parents who remember experiencing food insecurity [90]. ...
Article
Full-text available
The process of feeding is complex and highly dependent on parent, child, social, and environmental factors. Given the rising rates of food insecurity and concomitant poor nutrition and health, the purpose of this article was to outline the important and complex ways in which the context of food insecurity can impact parent feeding practices. Key factors discussed here include the impact of food insecurity on: expectations for motherhood, structural constraints, stress and depression, parents’ perceptions of health and child weight, and intergenerational transmission of parent feeding practices. Future research needs are also identified and discussed.
... FI in adulthood when used with adults). However, there are suggestions in the literature that FI or related deprivation experienced during childhood have a developmental programming effect on adult food-related behaviour (Hill et al., 2016;Olson, Bove, & Miller, 2007). That is, having experienced childhood FI may be related to adult food motivation, even after controlling for current FI. ...
... One way of interpreting this finding is that individuals who have experienced childhood FI behave as if food insecure in adulthood, regardless of whether they actually are or not. This interpretation would be compatible with previous descriptions of the impact of childhood poverty, deprivation or trauma on adult body weight and eating (Greenfield & Marks, 2009;Hill et al., 2016;Olson et al., 2007). Our study goes beyond the prior research in specifically measuring and examining childhood FI, as opposed to more general socioeconomic or psychosocial adversities in childhood. ...
Article
Full-text available
Food insecurity is associated with high body weight for women but not men in affluent Western societies. However, it is not currently known what behavioural or psychological mechanisms drive this association. Moreover, it is also unknown whether only current experience of food insecurity in adulthood is important, or there are lasting effects of childhood experience. We carried out a mock 'taste test' where 126 adult volunteers had the opportunity to consume and rate energy-dense snack foods. Current food insecurity was measured using the standard USDA measure, and in addition, we used a novel measure that also captures childhood experience of food insecurity. As well as the expected gender-specific association between current food insecurity and body weight, we found some evidence for associations between food insecurity and calorie consumption in the taste test, and liking of one of the foods, chocolate. However, associations between current food insecurity and the outcomes were moderated by childhood experience of food insecurity, with greater childhood food insecurity enhancing the positive effect of current food insecurity on body weight, but attenuating the positive effect of food insecurity on calorie consumption and liking for chocolate. These findings are exploratory, but they suggest that any effects of food insecurity in adulthood on eating and the hedonic value of foods may be moderated by childhood experience.
... For example, there is some evidence that experiencing food insecurity as a child may influence parental practices when one becomes an adult. Parents report that their own childhood memories of deprivation make it hard to say no to their children's food requests (Herman, Malhotra, Wright, Fisher, & Whitaker, 2012;Olson, Bove, & Miller, 2007) and parents' childhood mealtime experiences influence later attitudes about family meals (Malhotra et al., 2013). In a study of current child feeding practices among Korean and Chinese immigrant mothers, researchers found that mothers who experienced food insecurity in childhood were less likely to be concerned about what their children ate or to perceive that their children were overweight (Cheah & Van Hook, 2012). ...
... As noted in the introduction, current household food insecurity has been linked to parental behaviors, concerns and feeding practices associated with poor child outcomes, including overweight (Bauer et al., 2015;Bronte-Tinkew et al., 2007) (Knowles et al., 2016). Researchers have also found that deprivation in childhood is associated with behaviors and attitudes in adulthood including emotional eating, placing high value on food and efforts to avoid food insecurity, providing large variety or quantity of foods to children, and avoiding foods associated with lean times in childhood (Kuyper et al., 2006;Olson et al., 2007). Given the constellation of demographic, environmental and psycho-social factors that characterize poverty in childhood, it is difficult to assess causal relationships. ...
Article
The objective of this study was to explore how low-income parents recall and describe childhood experiences with food insecurity. Little is known about how adults remember food insecurity experienced in childhood, yet there are potential implications for subsequent behavior including parents' willingness and ability to adopt recommended child feeding practices. To guide development of a measure of previous childhood food insecurity for research and screening purposes, we conducted interviews exploring parents' emic perspectives on these early life course experiences and reactions to potential survey items. A diverse group of 27 low-income mothers in New York State was interviewed in depth; data were coded and analyzed qualitatively for emergent themes. In recounting childhood memories, participants expressed strong emotions and strove to portray their parents positively, emphasizing that parents did their best to ensure that children "always had something to eat." Rather than dwell on food insecurity, participants preferred to share memories of family strategies to mitigate food shortages (e.g., asking relatives for money, "stretching" meals). Participants' memories of these strategies to increase food access and acceptability and adequacy of meals were summarized in a framework integrating key themes. The emotional salience of childhood food insecurity memories suggests that these experiences could have significant implications for parental adoption of child feeding recommendations and should be considered when designing nutrition interventions. Measurement challenges identified included adults' limited recall and awareness of food insecurity during childhood, stigma, and desire to portray parents positively. Qualitative analysis of rich, emic data on food insecurity experiences offered insights on the most relevant constructs to address in survey measures of this potential antecedent of current practices.
... Mothers who experienced ELFI are more likely to perceive their children as weighing less than ideal and overfeed children, given that both money and food are more available now (Cheah & Van Hook, 2012). Moreover, these mothers also had emotional attachment to and preferences for specific foods, resulting in overfeeding their children such foods (Allen & Wilson, 2005;Olson, Bove, & Miller, 2007). However, whether the associations between ELFI and child diet are mediated by maternal feeding practices have not been examined. ...
... Growing up in China's biggest city and a global financial center, these Shanghainese mothers may have been more exposed to the dramatic economic growth and Western influences on dietary changes in urban China, compared with the other two groups (Xiao & Nie, 2009). They may have desired but had limited access to processed and Western foods while growing up, and thus had specific emotional attachment to and preferences for these foods instead of F&V (Allen & Wilson, 2005;Olson et al., 2007). Despite their current middle-class status in China, nonmigrant mothers' ELFI experiences are still associated with their current feeding practices, and may motivate them to buy processed foods and strongly encourage their children to finish their plates (Cheah & Van Hook, 2012). ...
Article
Full-text available
Objective To examine whether mothers’ early-life food insecurity (ELFI), pressuring to eat feeding practices (PEP), and child effortful control (EC) are associated with child dietary intake within and across three Chinese ethnic groups. Method Participants included 119 Chinese international immigrants in the United States, 230 urban nonmigrant, and 468 rural-to-urban migrant mothers and preschoolers in China. Mothers reported on their ELFI, PEP, and their children’s EC and dietary intake. Results Controlling for maternal and child body mass index, age, and gender, multiple group path analyses revealed that maternal ELFI was positively associated with PEP in all groups, which in turn was positively associated with child unhealthy diet in all groups, but negatively associated with child fruits and vegetables (F&V) consumption in the urban nonmigrant group only. Also, EC was positively associated with child F&V diet for all groups. Moreover, the indirect effect of ELFI on children’s unhealthy diet through PEP was significant only for immigrant children with lower levels of EC, but not those with higher levels of EC. Conclusions Our findings highlighted the long-lasting effect of mothers’ ELFI on their feeding and child eating. Mothers’ pressuring to eat played a central role in the association between their past experiences and children’s diet. Also, children’s poor EC abilities might exacerbate the adverse effect of mothers’ ELFI through PEP, resulting in more unhealthy eating. These findings can contribute to the design of contextually based intervention/prevention programs that promote young children’s healthy eating through maternal feeding practices and children’s EC abilities.
... Volunteers who were deemed physically and mentally healthy at baseline developed intense preoccupation with food during the semi-starvation phase, and binge-eating behaviors emerged as more food was made available during the rehabilitation phase [37]. In line with these findings and the feast-or-famine cycle that many food-insecure individuals experience, qualitative research in low-income samples has highlighted patterns of food restriction and binge eating corresponding to fluctuations in food availability [38][39][40]. Food-insecure participants have described feeling immense excitement accompanying the influx of food after receiving a paycheck or SNAP benefits, particularly for favorite foods, as well as feeling out-of-control during overeating episodes [39], hence characterizing such episodes as binge-eating episodes [41]. Quantitative work in this area, however, has only recently begun to grow. ...
... In line with these findings and the feast-or-famine cycle that many food-insecure individuals experience, qualitative research in low-income samples has highlighted patterns of food restriction and binge eating corresponding to fluctuations in food availability [38][39][40]. Food-insecure participants have described feeling immense excitement accompanying the influx of food after receiving a paycheck or SNAP benefits, particularly for favorite foods, as well as feeling out-of-control during overeating episodes [39], hence characterizing such episodes as binge-eating episodes [41]. Quantitative work in this area, however, has only recently begun to grow. ...
Article
Full-text available
Purpose of Review This review summarizes emerging evidence for the relationship between food insecurity and eating disorder (ED) pathology, outlines priorities for future research in this area, and comments on considerations for clinical and public health practice. Recent Findings Among adults, food insecurity is cross-sectionally associated with higher levels of overall ED pathology, binge eating, compensatory behaviors, binge-eating disorder, and bulimia nervosa. Evidence for similar relationships among adolescents has been less robust; however, compared to studies of adults, there have been substantially fewer studies conducted in adolescents to date. Summary Emerging evidence consistently indicates that food insecurity is cross-sectionally associated with bulimic-spectrum ED pathology among adults. Findings emphasize the need for ED research to include marginalized populations who have historically been overlooked in the ED field. Much more research is needed to better understand the relationship between food insecurity and ED pathology and to determine effective ways to intervene.
... Childhood experiences predict food-related behaviour well into adulthood (Olson et al., 2007). One mechanism through which this occurs is due to a relationship between childhood socioeconomic status (SES) and adult self-control (Griskevicius et al., 2013). ...
... 7,8,35 However, VES, enhanced by previous experiences of food deprivation, may also be regulating current food choices by an emotional motivation. These results are consistent with Olson et al, 36 who affirmed that growing up poor may establish emotional attachments to food, such as an enhanced motivation to have an adequate food supply or excitement about having their preferred food available. ...
Article
Background In developing countries, where energy-dense foods with low nutrient content are highly accessible, the fear of feeling hungry and the desire of prolonging satiation have been documented. Objective To evaluate the role of valuation of eating and satiation in the relationship of food insecurity with diet, obesity, and cardiometabolic risk with structural equation modeling. Methods A validated questionnaire that measures the value of eating and satiation (VES) as the basis of wealth was administered to 321 adult women from Queretaro, Mexico. Instruments for measurement of socioeconomic status, food insecurity, physical activity, and a semiquantitative food frequency questionnaire were also applied. Women were measured and weighed, and they provided a fasting blood sample to determine lipid profile, glucose, and insulin concentrations. Structural equation models were used for prediction of the homeostasis model assessment–insulin resistance (HOMA-IR) index and triglyceride/high-density lipoprotein (HDL) cholesterol index. Results The models confirmed, with acceptable goodness-of-fit parameters, the mediation position of VES between past experiences of food insecurity and a greater intake of carbohydrates and its impact on obesity, and on the HOMA-IR and the triglyceride/HDL-cholesterol index. Conclusion Experiences of food insecurity may increase VES in women and influence eating behavior, increasing intake of sugars and starches in their diet, thus increasing the risk of obesity and cardiometabolic diseases such as diabetes. The understanding of essential values that induce unfavorable eating behavior in a population that has experienced past food insecurity may help to develop public health strategies for prevention of cardiometabolic diseases.
... Poverty, so common in Haredi communities (Cahaner et al. 2017), may increase risk for EDs (Johnson et al. 2002). Food scarcity is associated with compensatory eating (Olson et al. 2007), and the link consistently observed between food insecurity and high BMI appears to be explained by preemptive calorie intake (Basiotis and Lino 2003). Indeed, when Bratanova and his colleagues led people experimentally to see themselves as poor, they tended to increase their calorie intake (Bratanova et al. 2016). ...
Article
Full-text available
Little is known scientifically about eating disorders (EDs) in the Haredi (Jewish ultra-Orthodox) community. This paper aims to describe Haredi culture, review available peer-reviewed research on EDs in the Haredi community and discuss possible risk and protective factors for these disorders in a culturally informed way. A literature search for 2009–2019 yielded 180 references of which only nine were studies on ED in the Haredi community. We describe these and use them as a basis for discussion of possible risk and protective factors for ED in Haredi women. Risk factors may include the centrality of food, poverty, rigid dress codes, the importance of thinness for dating and marriage, high demands from women, selflessness and early marriage and high expectations from women. Protective factors may include faith, Jewish laws governing eating and food that encourage gratitude and mindful eating, and body covering as part of modesty laws that discourage objectification. Ways of overcoming the current barriers to research in the Haredi community should be sought to advance ED prevention and treatment in this population.
... Indeed, many clients -both thin and fat-seemed to make the most of any opportunity for free food, whether from the candy jar we set out at Halloween or the pizza served that evening, even if it meant breaching a few social norms. Given the relationship between poverty, food insecurity, disordered eating, and higher body weight (Olson, Bove, and Miller 2007), this is not terribly surprising. What did surprise me, however, was learning that a client's chances of leaving her appointment "interview ready" decreased dramatically as her body size increased, a finding that brings new irony to critiques of WTW programs as "one size fits all." ...
Article
Drawing on 13 months of participant observation at a welfare‐to‐work nonprofit that provides unemployed poor women with used business attire, I assess the extent to which—and how—this “objectified cultural capital” is transmitted to clients. I advance prior theorizing in this area by considering whether clients’ “bodily capital” impacts the services they receive. I find that despite providing needed services to clients, the organization reifies many of the inequalities it seeks to remedy. When sorting clothing donations, staff and volunteers curate particularly classed embodiments by selecting garments that are work‐appropriate yet not luxurious. Also, well‐intentioned efforts to provide a luxurious shopping‐esque experience for clients ironically produces service scripts that facilitate control over clients’ behavior. Finally, service interactions reproduce inequities between different types of clients along the lines of race, class, and body size, such that clients with more privileged bodily capital fare better than those with stigmatized embodiments. I use these findings to caution against romanticized understandings of philanthropic efforts to remedy social inequality, while also underscoring the importance of taking embodiment—particularly the striking social disadvantages of larger body size—into account when examining the intersections of gender, race, and class.
... 159 For example, lack of full grocery facilities in low-income areas, [160][161][162] SUMMARY OF THE GREY LITERATURE NIHR Journals Library www.journalslibrary.nihr.ac.uk reliance on public transport by people on low incomes, 163 relatively high cost (and poorer quality) of healthy foods as compared with less healthy foods in lower-income neighbourhoods, 164,165 prevalence of fast-food-type outlets in low-income communities (and, in particular, near schools) [166][167][168] and limited access to health care. 169 In addition, eating behaviours of people with FI, for example overeating when food is available, [170][171][172] and the psychological aspects of being food insecure, such as stress, depression and anxiety, may also be contributing factors. 47,173 Of particular relevance to children in lower-income neighbourhoods may be the lack of opportunities for physical activity. ...
Article
Full-text available
Background Food insecurity (FI) is a multifaceted, socioeconomic problem involving difficulties accessing sufficient, safe and nutritious food to meet people’s dietary requirements and preferences for a healthy life. For children experiencing FI, there are some potentially negative developmental consequences and it is, therefore, important to understand the links between FI and children’s health and well-being as well as any strategies undertaken to address FI. The overall objective of this assessment was to determine the nature, extent and consequences of FI affecting children (aged ≤ 18 years) in the UK. Objective To determine the nature, extent and consequences of FI affecting children (aged ≤ 18 years) in the UK. Data sources The databases searched on 4 December 2017 included MEDLINE (including In-Process & Other Non-Indexed Citations and E-pub ahead of print files), EMBASE, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Commonwealth Agricultural Bureaux (CAB) abstracts, The Cochrane Library, Education Resources Information Centre (ERIC), PsycINFO, the Social Science Citation Index and the Applied Social Sciences Index and Abstracts (ASSIA). Methods A rapid review of the current published and unpublished literature was conducted, including all study designs from specified high-income countries in children aged ≤ 18 years. Searches were conducted of major health-care, nutrition, education and social science databases from 1995 onwards, and websites of relevant UK and international organisations. Final searches were undertaken in December 2017. Results In total, 109 studies were selected. Only five studies were conducted in the UK, four of which provided qualitative data. Possible factors associated with child FI were identified, for example socioeconomic status, material deprivation, living in public housing and having unemployed or poorly educated parents. Children’s health, well-being and academic outcomes were all negatively affected by FI. The mediating effects of family stressors and parenting practices in the relationship between FI and children’s health and well-being outcomes were not clear. Food assistance programmes were generally effective in mitigating FI and improving nutritional outcomes (including hunger) in the short term, but did not eradicate FI, eliminate its effects on children’s health or have an impact on academic outcomes. No reports assessing the prevalence of child FI in the UK or the cost-effectiveness and sustainability of interventions to tackle FI were identified. Limitations There was a lack of consistency in how FI was defined and measured across studies. Most of the studies used indirect measurements of child FI through parental reports. The majority of studies were conducted in North America. Only five studies were conducted in the UK. Thirty potentially relevant studies were not included in the review as a result of time and resource constraints. Most studies were observational and caution is advised in interpreting their results. Conclusions A number of factors that were related to child FI were identified, as were negative associations between child FI and physical, mental and social outcomes. However, these findings should be interpreted with caution because of the correlational nature of the analyses and the fact that it is difficult to determine if some factors are predictors or consequences of FI. Future research There is an urgent requirement for the development of a reliable instrument to measure and monitor child FI in the UK and for well-designed interventions or programmes to tackle child FI. Study registration This study is registered as PROSPERO CRD42017084818. Funding The National Institute for Health Research Public Health Research programme. The Health Services Research Unit is core-funded by the Chief Scientist Office of the Scottish Government Health and Social Care Directorates.
... These psychological dimensions may persist long after periods of food inadequacy resolve (112). Adults who experienced food shortages as children sometimes describe lifelong patterns of disordered eating practice, such as bingeing when food is available or food hoarding (91). ...
Article
Full-text available
Food insecurity affects 1 in 8 US households and has clear implications for population health disparities.We present a person-centered, multilevel framework for understanding how individuals living in food-insecure households cope with inadequate access to food themselves and within their households, communities, and broader food system. Many of these coping strategies can have an adverse impact on health, particularly when the coping strategies are sustained over time; others may be salutary for health. There exist multiple opportunities for aligning programs and policies so that they simultaneously support food security and improved diet quality in the interest of supporting improved health outcomes. Improved access to these programs and policies may reduce the need to rely on individual- and household-level strategies that may have negative implications for health across the life course. Expected final online publication date for the Annual Review of Public Health Volume 40 is April 1, 2019. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
... Scholars and researchers commonly use qualitative methods for analysing food security which includes ethnographic techniques such as participant observation, in-depth interviews and focus group discussion on individual and household experiences of food insecurity. The application of qualitative interviews has allowed researchers to develop a more nuanced understanding of not only the experience and management of income-related food insecurity but also the greater psychological, physiological and emotional consequences associated with food insecurity (Hamelin et al. 1999;Olson et al. 2007). It also uses open-ended questions designed to capture judgements and perceptions and allow complex analyses of often non-quantifiable cause-and-effect processes. ...
Article
Full-text available
The concept of food security is dynamic and ever-changing. This article tries to highlight the concept of food security and its changing dimensions with respect to space and time. The article examines the shift of the concept from aggregate food availability, which is a function of domestic agricultural production, trade and food aid focusing on the supply side, to food accessibility which is a function of income or purchasing power focusing on the demand side. The analysis here also incorporates other dimensions of food security such as food stability, food utilization, food vulnerability, food sustainability, risk measurement, anthropometry, etc. Moreover, apart from providing a comprehensive picture of the evolution of the different dimensions of food security historically, the present article also tries to present the involution of the concept of food security in such a way the that it can be easily understood. Also reviewed here are the indicators and measurement processes that are currently being used by scholars of different organizations and institutions for the analysis of food security. The article concludes that the concept of food security is a dynamic and vital phenomenon and there is no benchmark or standard method to measure food security. Thus, researchers and policy makers should very judiciously choose the indicators while keeping in mind what dimension of food security they are going to deal with.
... Food-insecure households in general consume cheap, energy-dense foods and experience intermittent patterns of eating less when resources are limited and overeating when resources are readily available (47) . This results in drastic changes in food intake, which in turn could contribute to weight gain (48) . With respect to SES and FAS, our results showed that food insecurity scores increased with lower SES and FAS. ...
Article
Full-text available
Objective The present study aimed to assess the: (i) internal structure of the Spanish Child Food Security Survey Module (CFSSM-S) with exploratory and confirmatory factor analysis (EFA and CFA); (ii) measurement invariance by gender, grade, weight status, socio-economic status (SES) and family affluence; and (iii) relationships with these external variables. Design A cross-sectional study was conducted. The CFSSM-S and other tools were employed to assess food insecurity, weight status, SES and family affluence, respectively. Setting A secondary school (grades 7–10) in the city of Terrassa in Catalonia, Spain. Subjects Participants included adolescent boys and girls ( n 426) aged 12–17 years. Results The cross-validation design with EFA and CFA captured a single factor, ‘food insecurity’. The goodness-of-fit for the one-factor model with CFA (root-mean-square error of approximation=0·038, comparative fit index=0·984, Tucker–Lewis index=0·979) and internal consistency ( ω =0·95) were excellent. The measurement invariance indicated that CFSSM-S could be used across genders, grades, weight status, SES and family affluence. Only mean differences for SES and family affluence were found which showed a linear trend, indicating higher CFSSM-S scores for participants with lower SES and family affluence. Of participants, 1·9 % experienced very low food security, 16·4 % low food security and 81·7 % were food secure. Conclusions The CFSSM-S is the first validated instrument to assess food insecurity with psychometric guarantees in Spanish adolescents. Researchers and health practitioners in Spain could use this self-reported questionnaire to gain more information about adolescent health in relation to food insecurity.
... In West Africa, unhealthy eating starts early with parents feeding their children (as young as 6 months old) sweetened pap (a popular breakfast cereal and infant weaning food in Nigeria made from fermented maize) and sugary snacks (Bosu, 2015). These children may grow up and adopt these poor eating habits, which could also include the inadequate consumption of fruits and vegetables (Craigie et al., 2011;Lake et al., 2006;Mikkila et al., 2004;Olson et al., 2007). For example, in Ouagadougou, Burkina Faso, this is exemplified by a mere 4% of 12-year-old children who reported eating fruits or vegetables daily (Bosu, 2015). ...
Article
Background: In Nigeria and many parts of sub-Saharan Africa, the availability of foods that are high in salt, sugar, and saturated fat is steadily increasing. This has led to an increase in the consumption of such foods among Nigerians, particularly among adolescents. Aim: This pilot study was undertaken to understand whether, and how, gamification of nutrition can have an impact on addressing the problem of unhealthy eating among Nigerian adolescents. Methods: Gamification of nutrition through board games, clubs and vouchers was introduced in three secondary schools in Abuja, Nigeria over a span of three to four months. Semi-structured focus groups were conducted with grade 11 and 12 students in the three secondary schools. Participants were asked about their perceptions of the intervention and how it influenced their eating behaviour, attitudes and knowledge about nutrition. Results: A total of 31 students participated in four focus groups. Participants reported that the intervention shifted their perceptions and preferences, leading them to alter their behaviour by incorporating more nutritious foods (such as fruits and vegetables) into their diet and engaging in more physical activity. Five themes emerged from the analyses: improved eating behaviour; increased physical activity; improved overall well-being; increased nutrition knowledge; and influencing others. Conclusions: The results from the focus groups suggest that gamification of nutrition can lead to improvements in dietary behaviour among adolescents over the short-term. More studies are needed to evaluate the long-term effects of nutrition interventions that use gamification techniques.
... Second, parents who described suffering from hunger or limited incomes in the past tried to avoid giving the child the same experience, even if this meant not having healthy food at home. Previous studies reported that parents who experienced food insecurity in childhood prioritized their child's diet over other needs (42) and quantity over quality of food (43). This consequence of food insecurity could be considered a risk factor for childhood obesity because parents may lose control of the amount and quality of foods the children are eating. ...
Article
Objective Childhood obesity is considered one of the most important public health problems around the world. Chile is currently one of the Latin American countries with a high prevalence of childhood obesity. Given that parents’ food parenting practices shape their children’s lifelong eating habits, addressing those practices is key to curbing later problems of obesity. However, studies of the influences on Chilean parents’ food parenting practices are scarce. Hence, this study explores factors that influence food parenting practices of preschool-aged children in Chile. Design Qualitative research, using interviews with the photo-elicitation technique. Setting Metropolitan Region, Chile Participants Twenty-five parents from families recruited from public childcare centers. Results Through a thematic analysis with an inductive approach, we identified five themes that influence food parenting practices: 1) Parents’ previous experiences and how they determine their current goals and beliefs; 2) Responses to the child’s characteristics; 3) The influences of other family members, especially grandparents; 4) Parents’ nutritional knowledge; 5) Living contexts, especially limited budgets and lack of time. Conclusions The study reveals multilevel influences, which converge at the family level, on food parenting practices. A family-centered approach that addresses the mentioned influences is necessary to improve the management of the childhood obesity problem in Chile.
... As societies shift to industrial food production and a Westernized diet, rates of obesity increase markedly, but not all individuals become fatter to the same extent [62]. The way individuals respond to the food environment of adulthood may, in part, relate to childhood experience [63,64]. Thus, our findings in the starling may be relevant, at least as a proof of principle, to a broad range of species and problems. ...
Article
Full-text available
Animals require strategies for coping with periods when food is scarce. Such strategies include storing fat as a buffer, and defending the rate of energy intake by changing foraging behaviour when food becomes difficult to obtain. Storage and behavioural defence may constitute alternative strategies for solving the same problem. We would thus expect any developmental influences that limit fat storage in adulthood to also induce a compensatory alteration in adult foraging behaviour, specifically when food is hard to obtain. In a cohort of hand-reared European starlings, we found that higher manipulated early-life begging effort caused individuals to maintain consistently lower adult body mass over a period of two years. Using an operant foraging task in which we systematically varied the costs of obtaining food, we show that higher early-life begging effort also caused stronger behavioural defence of the rate of energy intake when food was more costly to obtain. Among individuals with the same developmental history, however, those individuals who defended their rate of energy intake most strongly were also the heaviest. Our results are relevant to understanding why there are marked differences in body weight and foraging behaviour even among individuals inhabiting the same environment.
... Although three-quarters of the rural mothers rated their general health as being excellent, very good, or good, paradoxically, about the same percentage is considered either overweight or obese as measured by the Body Mass Index (BMI) (Mammen & Sano, 2013). Mothers growing up poor or in a food-insecure household were more likely to engage in binge-like eating that resulted in adult obesity (Olson, Bove, & Miller, 2007). Families from the most food-insecure states applied risky strategies to cope with food inadequacy such as deliberately restricting food, reducing appetite by smoking or drinking soda, and conducting triage where younger children, children in general, and adult men were fed before older children, adults, and adult women, respectively (Mammen, Bauer, & Richards, 2009). ...
Article
Full article available at: https://www.tandfonline.com/eprint/3XXEGZGuhxZtE4RQ6Ejv/full. Rural, low-income families are disproportionately impacted by health problems owing to structural barriers (e.g., transportation, health insurance coverage) and personal barriers (e.g., health literacy). This paper presents a Participatory Action Research (PAR) model of co-created Core Health Messages (CHMs) in the areas of dental health, food security, health insurance, and physical activity. The research project engaged a multi-disciplinary team of experts to design initial health messages; rural, low-income mothers to respond to, and co-create, health messages; and stakeholders who work with families to share their insights. Findings reveal the perceptions of mothers and community stakeholders regarding messages and channels of message dissemination. By using PAR, a learner engagement approach, the researchers intend to increase the likelihood that the CHMs are culturally appropriate and relevant to specific populations. The CHM-PAR model visually illustrates an interactive, iterative process of health message generation and testing. The paper concludes with implications for future research and outreach in a technological landscape where dissemination channels are dynamic. This paper provides a model for researchers and health educators to co-create messages in a desired format (e.g., length, voice, level of empathy, tone) preferred by their audiences and to examine dissemination methods that will best reach those audiences.
... We should expect that the vernacular traditions of societies that collectively experience extensive hunger should contain more food-related content, and content about the satisfaction of immediate need, than the traditions of societies where hunger is rare. These effects will be particularly likely to be visible if, as has been suggested, frequent exposure to hunger over the life course leaves a psychological residue, so that individuals continue to behave as if currently hungry even when they are not (Bloxham et al., 2014;Olson et al., 2007). The kinds of predictions described above would be testable with cultural traditions as the unit of analysis. ...
Article
Full-text available
Individuals cope with their worlds by using information. In humans in particular, an important potential source of information is cultural tradition. Evolutionary models have examined when it is advantageous to use cultural information, and psychological studies have examined the cognitive biases and priorities that may transform cultural traditions over time. However, these studies have not generally incorporated the idea that individuals vary in state. I argue that variation in state is likely to influence the relative payoffs of using cultural information versus gathering personal information; and also that people in different states will have different cognitive biases and priorities, leading them to transform cultural information in different ways. I explore hunger as one example of state variable likely to have consequences for cultural evolution. Variation in state has the potential to explain why cultural traditions and dynamics are so variable between individuals and populations. It offers evolutionarily-grounded links between the ecology in which individuals live, individual-level cognitive processes, and patterns of culture. However, incorporating heterogeneity of state also makes the modelling of cultural evolution more complex, particularly if the distribution of states is itself influenced by the distribution of cultural beliefs and practices.
... The potential role of life-history strategies in obesity is indicated by the well-known association between low socioeconomic status (SES) and obesity (11)(12)(13). Conditions associated with low SES include uncertainty and resource scarcity, reflecting the type of harsh and unpredictable conditions that promote the development of fast life-history strategies. Indeed, recent work showed that low childhood SES is associated with a tendency among adults to eat even when nourishment is not currently needed (14; also see ref. 15). ...
Article
Full-text available
The association between low socioeconomic status (SES) and obesity is well documented. In the current research, a life history theory (LHT) framework provided an explanation for this association. Derived from evolutionary behavioral science, LHT emphasizes how variability in exposure to unpredictability during childhood gives rise to individual differences in a range of social psychological processes across the life course. Consistent with previous LHT research, the current findings suggest that exposure to unpredictability during childhood (a characteristic common to low SES environments) is associated with the adoption of a fast life-history strategy, one marked by impulsivity and a focus on short-term goals. We demonstrate that a fast life-history strategy, in turn, was associated with dysregulated weight-management behaviors (i.e., eating even in the absence of hunger), which were predictive of having a high body mass index (BMI) and being obese. In both studies, findings held while controlling for participants' current socioeconomic status, suggesting that obesity is rooted in childhood experiences. A serial mediation model in study 2 confirmed that effects of childhood SES on adult BMI and obesity can be explained in part by exposure to unpredictability, the adoption of a fast life-history strategy, and dysregulated-eating behaviors. These findings suggest that weight problems in adulthood may be rooted partially in early childhood exposure to unpredictable events and environments. LHT provides a valuable explanatory framework for understanding the root causes of obesity.
... Multiple interpretations have been developed to address the influence of social inequalities on obesity. Several researchers favour a materialist interpretation, pointing out the negative impact of poverty, material deprivation, economic insecurity and discrimination on food practices and lifestyles (McIntyre, 2004;McLaren, 2011;Olson, Bove, & Miller, 2007). Others, following Bourdieu's work on distinction (Bourdieu, 1984), suggest that the influence of social position on obesity operates mostly at a symbolic level (De Saint Pol, 2010;Fischler, 2001;Mennell, Murcott, & van Otterloo, 1992;Poulain, 2009). ...
Article
Over the last two decades, childhood obesity has emerged as a major public health issue in Switzerland. Health professionals and public health organisations now frame this condition as a disease that requires medical intervention. In this article, I report the findings of an ethnographic study conducted in a Swiss hospital program for the management of childhood obesity. The study explored the impact of the medical treatment of childhood obesity on children’s lives. Using a Bourdieusian approach to guide my analysis, I found that the experience of the therapy varies substantially according to children’s socioeconomic position. Children with a high SES seem to encounter less difficulties in adapting their lifestyle to professionals’ recommendations than low SES children, because their habitus facilitates the internalisation of health norms and they have greater access to economic, social and cultural capitals. Therefore, childhood obesity management tends to reproduce health inequalities between children.
... In the U.S., 15% of the population has FI. FI is much higher (34.5%), however, in families below the poverty level [45] and is associated with overweight and binge eating [46]. Further, FVC is strongly connected with diet quality in addition to quantity and FI with undernutrition [2] as well as obesity [2,4]. ...
Article
Full-text available
Background: Maternal Depression (MD) has been implicated in the etiology of obesity. The present study investigated MD and both child fruit/vegetable consumption (FVC) and household food insecurity (FI) in an early childhood population. Methods: This cross-sectional study was conducted in Arkansas, United States, in 26 Head Start centers. Teachers obtained the Family Map (FM), an interview assessment tool used by Head Start staff to identify potential risk factors that affect child learning and development. The FM contains a two-item screener of parent depression—the Patient Health Questionaire-2, two questions about family FI, and two questions about FVC. The FM was completed in 693 households. Chi square analyses and logistic regressions utilizing adjusted and unadjusted odds ratios were utilized to compare differences in risk for children of mothers with no symptoms compared to mothers with low- or high-level depressive symptoms. Results: Children whose mothers had high MD were 2.90 (CI: 1.21–7.00) and 7.81 (CI: 3.71–16.45) times more likely to be at risk for low FVC and FI, respectively, compared to children of mothers with no MD. Similar findings but at lower magnitude were found for mothers with low symptoms of MD in comparison with mothers with no MD—both for Low FVC (1.57 times more likely; CI: 1.01–2.45) and FI (2.14 times more likely; CI: 1.28–3.58). The results presented are Odds Ratios from the multivariable adjusted models. Conclusions: Implications for the etiology of obesity, prevention/intervention efforts, and future research are offered, including recommended addition of maternal depression and household FI screening in early childhood programs.
... First, the robust connection of household income with adequate nutrition has been established, where low socioeconomic status limits the access to high quality food and adequate diets [20]. That is, low income status is related to non-adherence to science-based recommendations, or known as food-based dietary guidelines, which adversely influences health [21]. On the other hand, individual physical activity has been connected to food intake as working body requires more energy to burn [22]. ...
Article
Full-text available
Albeit the potent association between nutrition and health has been repeatedly corroborated in the field of nutrition science through evidence-based approaches, the prevalence of inadequate nutrition among Filipino households is still too high. Therefore, the goal of this study was to pinpoint nutrition challenges faced by Filipino young adults and evaluate whether a personalized nutrition knowledge-based system is a potential nutrition intervention tool. A mixed-methods needs analysis approach was operated to arrive at a panoramic profile of a nutrition knowledge-based system through the participation of respondents in an online survey (n = 85) and focus groups (n = 4). The assessment was grounded from the influencing factors of health and nutritional status such as food selection, nutrition barriers, poor eating habits, nutrition knowledge, and with the inclusion of nutrition application for technical feedback. The findings exploited the fact that people do not track what they eat, let alone the nutrients it contained, which eventually leads to undereating or overeating. There was also a commonness in lack of nutrition knowledge to make healthier food choices. Fortunately, the willingness of participants to point their directions towards a healthier lifestyle through the use of a nutrition knowledge-based system was evident. The paper then concluded with recommendations for future studies and how its findings might be utilized for the development of a personalized nutrition system.
... Due to uncertain food availability, physiological and psychological hunger can increase the likelihood of binge eating (West et al., 2019). Olson et al. (2007) also found a cycle of limitations and overeating in food insecure households, where when a family is able to get food, binge eating will occur. Meanwhile, when there is not enough food, parents will tend to limit the food consumed (Castner and Henke, 2011). ...
Article
Full-text available
Teenage phase is a critical period of psychosocial development. Adolescent eating patterns are formed in this phase. Household food security is among factors which may infl uence eating pattern. Adolescent who are exposed to food insecure condition tend to experience stress, which one of the coping mechanisms is overeating and may develop binge eating disorder. The purpose of this study is to analyze association between household food security status and binge eating disorder in adolescent. This case control study involved 74 adolescents aged 16-18 years and their parents in Semampir District, Surabaya, Indonesia who were selected randomly using simple random sampling. Household food security was assessed by using the Household Food Insecurity Access Scale (HFIAS) and binge eating disorder is assessed by using Eating Disorder Diagnostic Scale (EDDS). The association between household food security and binge eating disorder was analyzed by Spearman’s correlation test. There was an association between food security status (p = 0,001) and binge eating disorder. Further analysis showed that adolescents at risk of food insecurity were 5,625 times more likely to experience a binge eating disorder. This study recommends to increase food security through economic empowerment of housewives and socialization about coping strategy for both parent and adolescent.
... International studies with children and adolescents have shown that food insecurity is directly associated with overweight [6][7][8][9] and with poor-quality diet characterised by the presence of less healthy foods more likely to lead to nutrient deficiencies 10,11 . In Brazil, that association has been observed in adults 12 , but is not yet clear in adolescents, where the relations found have been inverse 13 or null 14,15 . ...
Article
Full-text available
Resumo O objetivo deste estudo foi verificar as mudanças na prevalência do excesso de peso em adolescentes e sua associação com variáveis sociodemográficas e insegurança alimentar em período de 5 anos. Foram realizados dois estudos transversais com 511 (2005) e 314 (2010) adolescentes de 12 a 18,9 anos residentes de Campos Elíseos (Duque de Caxias-RJ). Excesso de peso foi avaliado por meio do IMC (peso/estatura²). A insegurança alimentar foi investigada por meio da Escala Brasileira de Insegurança Alimentar (EBIA). Utilizou-se regressão logística para verificar a associação entre as mudanças temporais de excesso de peso segundo sexo, idade, cor da pele, e insegurança alimentar. Quanto à evolução do excesso de peso pode se notar que nos meninos houve aumento significativo para os mais novos (20,1% para 49,5%), os de cor preta ou parda (22,2% para 37,3%), os que tinham renda per capita de até ½ salário mínimo (13,6% para 32,5%) e os que apresentavam insegurança alimentar moderada e grave (9,2% para 36,3%) entre 2005 e 2010. Conclui-se que o aumento do excesso de peso foi expressivo nos adolescentes residentes em área de insegurança alimentar, e os meninos mais novos, pretos ou pardos, de menor renda e residentes em lares com insegurança alimentar moderada e grave estão mais expostos a este aumento.
... FI is also associated with binging and overconsumption when food is available, which results in greater body fat accumulation in anticipation of future periods of food scarcity [ 32 ]. It has been hypothesized that children raised in food-insecure or impoverished households carry such behaviors into adulthood, providing another possible behavioral explanation for the link between childhood nutrition and adult cardiovascular risk [ 47 ]. Future prospective studies should explore the validity of this theory to better inform nutritional recommendations for children. ...
Article
Full-text available
Food insecurity (FI) – a state of limited access to nutritionally adequate food – is notably more prominent among patients with cardiovascular disease (CVD) than the general population. Current research suggests that FI increases the risk of cardiovascular morbidity and mortality through various behavioral and biological pathways. Importantly, FI is more prevalent among low-income households and disproportionately affects households with children, particularly those led by single mothers. These disparities necessitate solutions specifically geared towards helping these high-risk subgroups, who also experience increased risk of CVD associated with FI. Further, individuals with CVD may experience increased risk of FI due to the financial burden imposed by CVD care. While participation in federal aid programs like the Supplemental Nutrition Assistance Program and the Special Supplemental Nutrition Program for Women, Infants, and Children has been associated with cardiovascular health benefits, residual FI and lower dietary quality among many families suggest a need for better outreach and expanded public assistance programs. Healthcare systems and community organizations can play a vital role in screening individuals for FI and connecting them with food and educational resources. While further research is needed to evaluate sociodemographic differences in the FI-CVD relationship, interventions at the policy, health system, and community levels can help address both the burden of FI and its impacts on cardiovascular health.
... Food deprivation and overeating has been observed in low income, food insecure individuals. As a coping strategy to stretch the food budget, food insecure individuals often skip meals or eat less and when food becomes available, they often overeat [36,37]. In a study that sort to establish the relationship of food insecurity and food and nutrient intake, a significant decrease in the intake of fruits and vegetables were associated with increased severity of food insecurity. ...
... Before birth, undernutrition can result in intrauterine growth retardation (IUGR) which can cause small-for-gestation age (SGA), or low birth weight (LBW). Undernutrition among children presents as growth failure, underweight, wasting, and stunting (2)(3)(4)(5)(6)(7) . Traits of food insecure children mirror those of undernourished children including aggression, anxiety, attention deficit, depression, irritability, food allergy, frequent hospitalization, learning disability, and nutrients deficiencies (4,8,9,(11)(12)(13)(14)(15) . ...
Article
Objective This study provides information on food insecurity and child malnutrition in a technologically advanced nation. Design Population-based study using multistage probability cluster sampling design to collect survey data. Multivariable regression models were used to determine associations between food security status and various malnutrition indices. Setting We used a national sample from the United States National Health and Nutrition Examination Survey (NHANES) 2011-2014. Participants The anthropometric and demographic datasets of 4,121 children <7 years old were analyzed for this study. Results Food insecure infants younger than 6 months had shorter upper arm length (−0.4 cm, p=0.012) and smaller mid-upper arm circumference (−0.5 cm, p=0.004), likewise those aged 6 months-1 year who had shorter upper arm length (−0.4 cm, p=0.008), body length (−1.7 cm, p=0.007) and lower body weight (−0.5 kg, p=0.008). Food insecure children younger than 2 years were more likely to be underweight (OR: 4.34; 95% CI: 1.99-9.46) compared to their food secure counterparts. Contrarywise, food insecure children older than 5 years were more likely to be obese (OR: 3.12; 95% CI: 1.23-7.96). Conclusion Food insecurity associates with child growth deficits in the United States. Food insecure infants and young children are generally smaller and shorter, whereas older children are heavier than their food secure counterparts, implying a double burden of undernutrition-overnutrition associated with child food insecurity. Child food and nutrition programs to improve food insecurity should focus on infants and children in the transition ages.
... Emerging evidence suggests that SES may increase reinforcement pathology. Food restriction and deprivation, and even deprivation in the past, has been shown to increase RRV of food [24,29]. Additionally, laboratory research has shown that humans' desire for money and food tend to overlap, such that hungry adolescents desire more money and those primed with financial dissatisfaction tend to consume more energy [2]. ...
Article
Full-text available
Background In the United states obesity and socioeconomic status (SES), or one’s standing in society based on income, education, and/or occupation, are strongly associated. The mechanisms for this relationship may include having high levels of motivation to get food (reinforcing value of food; RRV) and low levels of inhibitory control (delay discounting; DD) which, when combined, is referred to as reinforcement pathology (RP). We sought to examine the relationships among multiple measures of household SES, RP, and age-adjusted body mass index (zBMI) among adolescents. Methods These data were collected as part of ongoing longitudinal study of risk factors for obesity in 244 adolescents. The adolescents and one parent/guardian had height and weight measured and completed surveys. The adolescents completed an adjusting amount DD task and a computer-based RRV task. Analyses consisted of correlations among measures of SES and RRV, DD, and BMI z-scores. In the case of significant associations, multiple regression models were created with theoretically informed covariates. Results Household income, parent/guardian education, parent/guardian occupation, and food insecurity status were all related to one another. Among the adolescents, a significant portion of the variance in RRV was accounted for by household income after controlling for covariates. For DD, it was parent/guardian education that was most associated after controlling for covariates. Conclusion When low income and low parent/guardian education occur together, there may be an increased risk of RP. Separately, food insecurity was predictive of higher parent/guardian BMI. Future research should continue to explore the effects of low income and parent/guardian education on RP among youth by examining them over time.
... In addition to the mechanisms described in the introduction of this paper, previous life experiences of food insecurity may heighten CVD risk, yet these remain uninvestigated hypotheses. For example, the experience of food deprivation as a child may have lifelong influence on eating patterns, attitudes, and preference in adulthood; some adults who experienced food shortages in childhood described longterm disordered eating practice, such as bingeing when food was available or food hoarding [44,45]. Food insecurity has also been associated with increased depressive symptoms and stress [13]. ...
Article
Full-text available
Purpose of Review This review examines the current epidemiological evidence for the relationship between levels of food insecurity and cardiovascular disease (CVD) outcomes among US adults > 17 years. Recent Findings Review of recent literature revealed that reduced food security was associated with decreased likelihood of good self-reported cardiovascular health and higher odds of reporting CVD-related outcomes such as coronary heart disease, angina, heart attack, peripheral arterial disease, and hypertension. Summary Existing evidence suggests a compelling association between each level of reduced food security and CVD risk with a particularly strong association between very low food security and CVD risk. Policies and public health-based strategies are needed to identify the most vulnerable subgroups, strengthen and enhance access to food assistance programs, and promote awareness and access to healthful foods and beverages to improve food security, nutrition, and cardiovascular health.
... The common experience of food insecurity among educators was recently documented among ECETs in 2 states as exceeding national averages. 42,43 Consistent with literature on the negative impact of maternal food insecurity on feeding practices, 46 ECETs' experiences with food insecurity may contribute to an unhealthy relationship to food that has the potential to interfere with their ability to role model for children and use best feeding practices. Ensuring that children ate enough was a common goal shared by teachers. ...
Article
Objective Studies on factors associated with nutrition practices in early care and education settings often focus on sociodemographic and programmatic characteristics. This qualitative study adapted and applied Belsky's determinants of parenting model to inform a broader exploration of Early Care and Education Teachers (ECETs) practices. Design Qualitative cross-sectional study with ECETs. Setting The researchers interviewed ECETs in their communities across a Southern state. Participants Purposive sampling was employed to recruit ECETs (n = 28) from Head Start or state-funded centers serving low-income families. Phenomenon of Interest Developmental histories of ECETs regarding food and nutrition, beliefs about child nutrition, and teaching interactions related to food. Analysis Qualitative interviews were coded using a deductive content analysis approach. Results Three distinct interrelationships were observed across the themes. First, rules and routines regarding food and mealtime in the educators' childhood often aligned with educator beliefs and behaviors at meals in their classroom. Second, some ECETs described motivations to leave a healthy food legacy for children in their class. Finally, an experience of food insecurity appeared in narratives that also emphasized making sure children got enough through various strategies. Conclusions and Implications The influence of ECET developmental histories and their related beliefs can be addressed through professional development and ongoing support. Future study should quantify model constructs in a larger sample and study their relationships over time.
... 24 We defined quantitative methods as those which use numbers as the basis for making generalizations about a phenomenon. 25 In order to capture work on "obesity" in its widest sense, we included studies that focused on diet and physical activity as both social and biological concepts directly linked to obesity. We excluded studies focusing on hospitalized populations, populations with chronic illnesses, and diseases or treatments which affect patients' diets (e.g. ...
Article
Full-text available
Objective To explore the combined use of quantitative and qualitative methods with a longitudinal perspective in the field of obesity diet and physical activity. Method A systematic scoping review following PRISMA guidelines. The databases searched were Web of Science, PubMed, and ASSIA. Results 1592 records were returned from the searches. In total, nine studies met the inclusion criteria and were included in the review. Authors of included studies mixed quantitative and qualitative methods to obtain a deeper understanding of their study subjects, but few documents use longitudinal data. Authors value the combination of methods and try to integrate the results in their conclusions. Conclusions Total integration is rarely achieved in the analysis. The origin of this divergence can be found in the lack of theoretical guidance in these articles, but also in the difficulty of working in multidisciplinary teams in the field of obesity.
... Coping with food insecurity often includes a reliance on low-cost foods with binging when resources are available. Literature regarding adults has shown evidence of disordered or binge-type eating patterns among adults with food insecurity [32, 33, 34•], particularly when these adults had experienced food shortages as children [35]. ...
Article
Full-text available
Purpose of review: This 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 findings: While 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.
... In the U.S., 15% of the population has FI. FI is much higher (34.5%), however, in families below the poverty level [45] and is associated with overweight and binge eating [46]. Further, FVC is strongly connected with diet quality in addition to quantity and FI with undernutrition [2] as well as obesity [2,4]. ...
... While there are a variety of factors that contribute to high rates of obesity (Locard et al., 1992;McAllister et al., 2009;Weinsier, Hunter, Heini, Goran, & Sell, 1998), one factor that is known to impact one's risk is low childhood socioeconomic status (SES; Baum & Ruhm, 2009;Olson, Bove, & Miller, 2007). For example, longitudinal research examining environmental predictors of obesity in adolescents finds that time spent living in poverty before the age of nine is associated with higher body mass index (BMI) at age 17 (Wells, Evans, Beavis, & Ong, 2010), an effect that is mediated by greater exposure to factors such as crowding, noise, poor housing, separation from parents, exposure to violence, and family turmoil. ...
Article
A growing body of research indicates that one's early life experiences may play an important role in regulating patterns of energy intake in adulthood. In particular, adults who grew up under conditions characterized by low socioeconomic status (SES) tend to eat in the absence of hunger (EAH), a pattern that is not generally observed among higher-SES individuals. In the current study, we sought to examine (a) the environmental correlates of low SES that drive the association between low childhood SES and EAH and (b) whether the relationship between these variables is already manifest in children ages 3–14. Results of our study revealed that growing up in low-SES environments predicted less food security, diminished ability to meet financial needs, and less environmental predictability/safety. Further, the results indicated that reduced environmental predictability/safety in the children's environment interacted with children's current energy need to predict eating behavior. Consistent with patterns observed in adults, children from more predictable/safe environments ate food commensurate with their energy need, whereas those from less predictable/safe environments ate comparably high amounts of food across levels of energy need. These results offer needed insights into the development of environmentally-contingent energy-regulation strategies.
Article
Objective To explore the perspectives of urban-dwelling American Indian and Alaska Native (AI/AN) older adults regarding determinants of healthy eating, food insecurity, and opportunities for an urban clinic to improve resources. Methods Semistructured interviews (n = 24) with older adults (aged ≥ 60 years) at 1 urban AI/AN serving clinic. Telephone-based interviews were audio-recorded, professionally transcribed, and analyzed using thematic analysis. Results Four overarching themes were revealed: (1) hunger-mitigating resources exist but do not necessarily lessen food insecurity; (2) multiple layers of challenges related to social determinants of health present barriers to healthy nutrition for AI/AN older adults; (3) unique facilitators rooted in AI/AN culture can help decrease food insecurity; and (4) many clinic-based opportunities for programs to improve food insecurity exist. Conclusions and Implications Findings provide a foundation for urban-serving AI/AN clinics to develop healthy eating resources for their older adult patients. Greater benefit would result from resources that build on cultural strengths and address older adult-specific challenges to healthy eating.
Article
This study examined full-time recreational vehicle dwellers in the USA and revealed that mobile and stationary recreational vehicle dwellers were mainly the ‘young-old’ and those entering retirement ages, at an average of 60 years of age. Many recreational vehicle dwellers on limited incomes were found to occupy their recreational vehicles on a permanent basis. Because food security definitions require adequate space for food security, it was assumed that food strategies and food security in limited spaces such as the recreational vehicle might differ among mobile and stationary recreational vehicle dwellers based on their income levels and ability to comply with expected social and cultural standards for housing and recreational vehicle populations. By comparing mobile and stationary recreational vehicle dwellers and further grouping recreational vehicle dwellers as those over and under 65 years of age, this study examined how personal assessments varied in terms of kitchen space, food security and related household food strategies. This study focused on kitchen space assessments and their relation to food security. The stationary full-time occupancy of the recreational vehicles as primary housing is not regulated by law or housing codes. Thus, this study's results will be valuable to understanding aged individuals' housing perceptions and needs in order to provide foundational information for policy and regulation development for alternative housing, such as recreational vehicles and smaller dwellings.
Article
Background : Food insecurity, obesity, and psychological stress are interrelated constructs which are thought to be connected through increased energy intake, but the underlying mechanisms for these relationships remain unclear. The current study used experimental methods to investigate how financial losses may influence acute stress in the context of food insecurity for both parents and offspring. This study also sought to examine the effect of acute stress related to financial losses on the reinforcing value of food (RRVfood) and delay discounting (DD). Methods : One hundred and six families stratified by both offspring age (53 children aged 7-10, 53 adolescents aged 15-17) and household financial resources, visited our laboratory for three separate appointments. Each appointment included the experimental manipulation of financial gains and losses, saliva samples for cortisol assay, continuous heart rate monitoring, self-rated tension, and computer-based DD and RRVfood tasks. Participants also completed surveys to report perceived life stress level and food insecurity status. Results : Among all participants, financial losses were related to decreased heart rates and increased self-rated tension. Among parents reporting food insecurity, acute financial losses resulted in an increase in cortisol levels. Changes in cortisol, heart rate, and tension were not related to RRVfood or DD. Conclusion : Food insecure parents are sensitive to financial losses and respond with an increase in cortisol. However, we found no evidence for a relationship between cortisol and RRVfood or DD. This sensitivity to financial losses did not extend to children or adolescents.
Article
Objective To examine how household food insecurity is related to adolescent weight status and disordered eating. Design Cross-sectional, population-based study. Adolescents self-reported unhealthy weight control behaviours, binge eating and meal frequency; weight status was measured. Household food insecurity was assessed by asking parents to respond to the validated six-item US Household Food Security Survey Module. Setting Adolescents surveyed within Minneapolis/St. Paul public middle and high schools completed surveys at school, and their parents/guardians were surveyed by mail during the 2009–2010 academic year. Participants Ethnically/racially diverse, primarily low-income adolescents (mean age: 14·4 years, range: 10–22 years) and their parents/guardians ( n 2285 dyads). Results More than one-third (38·9 %) of the adolescents experienced past-year household food insecurity, 43·2 % reported disordered eating and 39·6 % were overweight. Generalised regression models showed that food insecure (FI) compared with food secure (FS) adolescents had higher prevalence of overweight (FI: 42·3 % v . FS: 37·9 %, P = 0·039), lower breakfast consumption (FI: 4·1 times/week v . FS: 4·4 times/week, P = 0·005) and greater use of unhealthy weight control behaviours (FI: 49·0 % v . FS: 39·5 %, P < 0·001) in unadjusted models. Models adjusted for parental education, ethnicity/race, sex and age found that food insecurity was associated with higher prevalence of unhealthy weight control behaviours (FI: 44·5 % v . FS: 37·8 %, P = 0·007), but not with weight status or other eating behaviours. Conclusions These results suggest that food insecurity may be an independent risk factor for unhealthy weight control behaviours, indicating a need to approach these intersecting issues in a comprehensive manner.
Article
Low-income families have elevated rates of both food insecurity and chronic diseases. Food purchases and consumption throughout the month may contribute to both outcomes. Four sets of focus groups (n = 21) aimed to better understand budgeting and purchasing strategies of Supplemental Nutrition Assistance Program participants. Content analysis was used to identify themes of food affordability and household purchasing power. Participants with consistent access to food reported budgeting, planning meals, strategically using public benefits, and limiting non-essential purchases. Individuals who used a combination of strategies such as meal planning, budgeting, and utilizing sales and coupons reported being better able to afford food throughout the month than those who did not.
Article
Childhood environments have lasting effects on individuals well into adulthood for a range of behaviours, and this holds true for food-related behaviours. In this study we ask how situational scarcity and individual self-control influence the relationship between early childhood financial adversity (ECFA) and unhealthiness of food choices. We propose situationally-experienced scarcity in adulthood may differentially influence individuals who did and did not experience financial adversity as a child in exercising self-control and in turn making less healthy food choices. Our study supports this prediction, finding high ECFA individuals to be more susceptible to situational scarcity such that there is an attenuation of self-control, resulting in greater unhealthy food choices. The moderating role of situational scarcity is more (vs. less) substantial for those who experienced higher (vs. lower) ECFA. These findings are further discussed in terms of implications for various audiences.
Article
The economic segregation of U.S. schools undermines the academic performance of students, particularly students from low-income families who are often concentrated in high-poverty schools. Yet it also fuels the reproduction of inequality by harming their physical health. Integrating research on school effects with social psychological and ecological theories on how local contexts shape life course outcomes, we examined a conceptual model linking school poverty and adolescent students’ weight. Applying multilevel modeling techniques to the first wave of data (1994–1995) from the National Longitudinal Study of Adolescent to Adult Health (Add Health; n = 18,924), the results revealed that individual students’ likelihood of being overweight increased as the concentration of students from low-income families in their schools increased, net of their own background characteristics. This linkage was connected to a key contextual factor: the exposure of students in high-poverty schools to other overweight students. This exposure may partly matter because of the lower prevalence of dieting norms in such schools, although future research should continue to examine potential mechanisms.
Article
Introduction: A review was conducted to examine the prevalence and risk factors of developing overweight and obesity in children residing in Gulf Cooperation Council (GCC) countries. Method: PubMed, Medline, and Google Scholar databases using PRISMA guidelines were searched from January 1, 2007, to January 1, 2017. The inclusion criteria were (a) studies written in English, (b) clinical trials that examined risk factors of childhood overweight or obesity, (c) studies involving children 5 to 10 years of age, and (d) studies conducted in GCC countries. Results: Three main types of childhood obesity risk factors were identified (individual, familial, and lifestyle behavioral factors). The dietary, physical activity, and screen time lifestyle behavior risk factor findings were inconclusive. Discussion: Childhood obesity is increasing in GCC countries. Lifestyle behavior risk factors are still unclear. Researchers need to use instruments that have been psychometric tested and culturally acceptable. A follow-up review should be conducted.
Article
Loss of control (LOC) eating is prevalent among adolescents and has been related to significant mental and physical health concerns. A growing body of research suggests that youth from lower income households are at risk for LOC eating. Food insecurity is an understudied contextual factor that may compound the risk for LOC eating in adolescents from low-income backgrounds. The present study sought to: 1) clarify the association between food insecurity and LOC eating among adolescents; and 2) examine whether household food insecurity moderated the association between income-to-needs and LOC eating. As part of a laboratory-based study, adolescents ages 12-17 (N=60; 33% from low-income households; 53.3% female) completed the Eating Disorder Examination-Questionnaire to measure LOC eating. Parents reported the household food insecurity status and household income, used to calculate income-to-needs ratio. Higher household food insecurity was positively associated with adolescent LOC eating (b=.662, t(59)=5.09, p<.01), after controlling for adolescent BMI percentile, race, ethnicity, biological sex, and age. Food insecurity significantly moderated the association between income-to-needs and LOC eating, ΔF(1,56)=11.99, p<.01, with the interaction effect explaining an additional 12% of variance. Specifically, lower household income-to-needs was associated with greater LOC eating among adolescents at higher levels of household food insecurity. This finding expands upon prior work by highlighting specific socioeconomic factors that place youth from low-income backgrounds at even greater risk for negative health outcomes. Future research is needed to understand potential ways to intervene for adolescents to prevent future LOC eating in the context of food insecurity.
Article
Obesity is considered one of the major health concerns of the 21st century and is frequently associated with economic development. This paper reviews evidence on internal (within countries) and external (across countries) relationships between obesity, income and gender. Obesity changes with income, but in a non-linear way. On average, obesity increases with income in poor countries, has no relationship with income in middle-income countries and decreases with income for rich countries. Within countries, obesity is concentrated among richer groups in low-income countries and evenly distributed in middle-income countries. In high-income countries, the poor are the most obese. The relationship differs for men and women. Women are more obese in low-income countries and much more obese in middle-income countries. The gender obesity gap disappears in high-income economies. The geographic concentration of obesity also changes with income growth: from urban areas in poor countries to rural areas in rich countries. Despite these patterns, total obesity rates continue to increase in all countries, and for the world as a whole.
Article
Cardiovascular disease is the leading cause of death and disability globally. Self-management of cardiovascular disease includes the consumption of nutrient-dense foods and prudent dietary patterns, such as the DASH (Dietary Approaches to Stop Hypertension) and Mediterranean Diet to decrease inflammation and stress. Over the last few decades, there has been a growing interest in food insecurity and health outcomes in the United States. While it is well established that diet plays a role in the development of cardiovascular disease, there is little known regarding the role of food insecurity and cardiovascular disease. As a result of unprecedented unemployment rates during and following the global COVID-19 pandemic, all dimensions of food insecurity have been impacted, including declines in food availability, accessibility, utilization, and stability. This paper summarizes the existing quantitative and qualitative literature exploring the social determinants of health (economics/poverty, employment, limited access to health care, and food) that affect the self-management of cardiovascular disease, including healthy nutrition, highlighting special considerations during the COVID-19 global pandemic.
Article
Full-text available
To identify factors in childhood which might influence the development of obesity in adulthood. The prevalence of obesity is increasing in the UK and other developed countries, in adults and children. The adverse health consequences of adult obesity are well documented, but are less certain for childhood obesity. An association between fatness in adolescence and undesirable socio-economic consequences, such as lower educational attainment and income, has been observed, particularly for women. Childhood factors implicated in the development of adult obesity therefore have far-reaching implications for costs to the health-services and economy. In order to identify relevant studies, electronic databases--Medline, Embase, CAB abstracts, Psyclit and Sport Discus-were searched from the start date of the database to Spring 1998. The general search structure for electronic databases was (childhood or synonyms) AND (fatness or synonyms) AND (longitudinal or synonyms). Further studies were identified by citations in retrieved papers and by consultation with experts. Longitudinal observational studies of healthy children which included measurement of a risk factor in childhood (<18 y), and outcome measure at least 1 y later. Any measure of fatness, leanness or change in fatness or leanness was accepted. Measures of fat distribution were not included. Only studies with participants from an industrialized country were considered, and those concerning minority or special groups, e.g. Pima Indians or children born preterm, were excluded. Risk factors for obesity included parental fatness, social factors, birth weight, timing or rate of maturation, physical activity, dietary factors and other behavioural or psychological factors. Offspring of obese parent(s) were consistently seen to be at increased risk of fatness, although few studies have looked at this relationship over longer periods of childhood and into adulthood. The relative contributions of genes and inherited lifestyle factors to the parent-child fatness association remain largely unknown. No clear relationship is reported between socio-economic status (SES) in early life and childhood fatness. However, a strong consistent relationship is observed between low SES in early life and increased fatness in adulthood. Studies investigating SES were generally large but very few considered confounding by parental fatness. Women who change social class (social mobility) show the prevalence of obesity of the class they join, an association which is not present in men. The influence of other social factors such as family size, number of parents at home and childcare have been little researched. There is good evidence from large and reasonably long-term studies for an apparently clear relationship for increased fatness with higher birth weight, but in studies which attempted to address potential confounding by gestational age, parental fatness, or social group, the relationship was less consistent. The relationship between earlier maturation and greater subsequent fatness was investigated in predominantly smaller, but also a few large studies. Again, this relationship appeared to be consistent, but in general, the studies had not investigated whether there was confounding by other factors, including parental fatness, SES, earlier fatness in childhood, or dietary or activity behaviours. Studies investigating the role of diet or activity were generally small, and included diverse methods of risk factor measurement. There was almost no evidence for an influence of activity in infancy on later fatness, and inconsistent but suggestive evidence for a protective effect of activity in childhood on later fatness. No clear evidence for an effect of infant feeding on later fatness emerged, but follow-up to adulthood was rare, with only one study measuring fatness after 7y. Studies investigating diet in childhood were limited and inconc
Article
Full-text available
Although individuals with poor food security might be expected to have reduced food intake, and thus reduced body fat and less likelihood of being overweight, these associations have not been adequately studied. The purpose of the current study was to examine the relationship between food insecurity and overweight as measured by body mass index (BMI) using data from the nationally representative 1994-1996 Continuing Survey of Food Intakes by Individuals (CSFII). Overweight was defined as BMI >27.3 kg/m(2) for women and 27.8 kg/m(2) for men. Food insecurity was related to overweight status for women (n = 4509, P < 0.0001), but not for men (n = 4970, P = 0.44). Excluding the 11 severely insecure women, the prevalence of overweight among women increased as food insecurity increased, from 34% for those who were food secure (n = 3447), to 41% for those who were mildly food insecure (n = 966) and to 52% for those who were moderately food insecure (n = 86). Food insecurity remained a significant predictor of overweight status, after adjustment for potentially confounding demographic and lifestyle variables (P < 0.01). In a logistic regression analysis, mildly insecure women were 30% more likely to be overweight than those who were food secure [odds ratio (OR) 1.3, P = 0.005]. Thus, food insecurity had an unexpected and paradoxical association with overweight status among women with a higher prevalence of overweight among the food insecure, and a resulting potential for increased incidence of obesity-related chronic diseases. Given that the rates of both overweight and food insecurity are on the rise, this research area warrants further investigation.
Article
Full-text available
Research into social inequalities in health has tended to focus on low socioeconomic status in adulthood. We aimed to test the hypothesis that children's experience of socioeconomic disadvantage is associated with a wide range of health risk factors and outcomes in adult life. We studied an unselected cohort of 1000 children (born in New Zealand during 1972-73) who had been assessed at birth and ages 3, 5, 7, 9, 11, 13, and 15 years. At age 26 years, we assessed these individuals for health outcomes including body-mass index, waist:hip ratio, blood pressure, cardiorespiratory fitness, dental caries, plaque scores, gingival bleeding, periodontal disease, major depression, and tobacco and alcohol dependence, and tested for associations between these variables and childhood and adult socioeconomic status. Compared with those from high socioeconomic status backgrounds, children who grew up in low socioeconomic status families had poorer cardiovascular health. Significant differences were also found on all dental health measures, with a threefold increase in adult periodontal disease (31.1% vs 11.9%) and caries level (32.2% vs 9.9%) in low versus high childhood socioeconomic status groups. Substance abuse resulting in clinical dependence was related in a similar way to childhood socioeconomic status (eg, 21.5% vs 12.1% for adult alcohol dependence). The longitudinal associations could not be attributed to life-course continuity of low socioeconomic status, and upward mobility did not mitigate or reverse the adverse effects of low childhood socioeconomic status on adult health. Protecting children against the effects of socioeconomic adversity could reduce the burden of disease experienced by adults. These findings provide strong impetus for policy makers, practitioners, and researchers to direct energy and resources towards childhood as a way of improving population health.
Article
Full-text available
Critical stages in childhood are suspected for adult obesity. We sought to identify (i) whether risk of adult obesity is influenced by childhood socioeconomic conditions in addition to those in adulthood; and (ii) whether conditions in childhood act independently or through their association with education or parental obesity. Longitudinal, 1958 British birth cohort. A total of 11 405 men and women followed to age 33 y. Social class at birth and ages 7, 11, 16, 23 and 33 y. Obesity (BMI> or =30) at age 33 y. Social class was related to obesity, cross-sectionally at ages 16 (women), 23 and 33 y, but not at younger ages. In analysis of adult obesity (age 33 y) and social class at five life stages, class at age 7 y significantly predicted obesity for women (adjusted odds ratio (OR)=1.31, that is, the odds increased by 31% for each decrease in social class). For men, class at birth and age 23 y predicted adult obesity (adjusted OR=1.19 and 1.16, respectively). Education was also associated with adult obesity, increasing the odds by 30% (men) and 35% (women) for each decrease in qualification level. Adjustment for education level and parental BMI did not abolish the effect on adult obesity of class at age 7 y among women, nor of class at birth among men, while class at age 23 y reduced to borderline significance. Cross-sectional associations for social class and obesity can be misleading and obscure effects of childhood socioeconomic conditions. Influences around birth to age 7 y have a long-lasting impact on the risk of adult obesity.
Article
Full-text available
To investigate the influence of social class in childhood, young adulthood and middle age, and intergenerational mobility, on adult central and total obesity. Prospective, population based, birth cohort study. Participants and Setting: 1472 men and 1563 women born in 1946 in England, Scotland, and Wales. Waist-hip ratio, waist-height ratio, waist circumference, and body mass index at age 53 years. Main results: Father's social class at participant's age 4 years was inversely associated with adult central and total obesity at age 53 years in men and women. For example, the mean difference of waist-hip ratio (95% confidence intervals) between father's professional social class I and unskilled manual social class V was 2.6% (0.7 to 4.6) for men and 2.5% (0.5 to 4.4) for women. The effect of father's social class remained after adjustment for participant's own social class in young adulthood and middle age. Both adult social classes were inversely related to obesity among women, but not men, after adjustment for childhood circumstances. Upwardly mobile men and women were less obese than participants remaining in their father's social class and their levels of obesity tended to be between the class they left and the class they joined. The effect of social class on adult obesity differed according to the stage in the life course at which social class was measured, and gender. Childhood circumstances had enduring influences on adult obesity, although our results on intergenerational mobility indicate potential reversibility of early life disadvantage.
Article
Full-text available
To examine socioeconomic differences in obesity using several different socioeconomic indicators, ranging from childhood socioeconomic environment and adult socioeconomic status to material resources and economic satisfaction. The data derived from the Helsinki Health Study baseline surveys in 2000 and 2001. Respondents to postal surveys were middle-aged employees of the City of Helsinki (4,975 women and 1,252 men, response rate 68%). Associations between eight socioeconomic indicators and obesity (BMI > or = 30 kg/m(2)), calculated from self-reported data, were examined by fitting a series of logistic regression models. In women, all socioeconomic indicators except household income and economic satisfaction were associated with obesity. Parental education and childhood economic difficulties, i.e., socioeconomic conditions in childhood, remained associated with obesity after adjusting for all indicators of current socioeconomic position. Indicators of adult socioeconomic status, own education and occupational class, were no longer associated with obesity when childhood socioeconomic conditions were adjusted for. Home ownership and economic difficulties were associated with obesity after full adjustments. In men, the findings paralleled those among women, but few associations reached statistical significance. Obesity was associated with several dimensions of socioeconomic position. Childhood socioeconomic disadvantage was associated with obesity independently of the various indicators of current socioeconomic position. Associations between obesity and both educational level and occupational class disappeared after adjustment for other indicators of socioeconomic position. This suggests that the variation observed in the prevalence of obesity by these key socioeconomic indicators may reflect differences in the related material resources.
Article
Full-text available
Our objective was to investigate the contribution of childhood and adult socioeconomic position (SEP) to adult obesity and smoking behaviour, in particular to establish the role of childhood circumstances across different studies in Europe and the US. Seven population-based surveys in six Western countries (Britain, Denmark, Finland, Netherlands, Sweden, US) were examined, with participants aged 30-50 yr and born between 1910 and 1960. Adult smoking was analysed using three outcomes (ever, current, or ex-) and adult obesity was defined as body mass index (kg/m(2)) > or =30. A strong effect of adult social position was observed for smoking outcomes and obesity. For example, manual SEP in adulthood increased the risk of ever smoking (adjusted odds ratio (OR) 1.47-2.00 for men; 0.94-1.81 for women), and obesity (adjusted OR 1.06-2.24 for men, 1.21-3.26 for women). In most studies, childhood position was not associated with ever-smoking. For current smoking, manual childhood position was associated among women (adjusted OR 1.09-1.54), but no consistent pattern was seen for men. For ex-smoking, manual childhood origins lowered the chance of quitting among women (adjusted OR 0.64-0.81) except in the US (OR = 1.17); among men this association was seen in fewer studies (adjusted OR 0.74-1.09). For obesity, manual origins increased the risk for women (adjusted OR 0.96-2.50); effects were weaker among men but mostly in the same direction (adjusted OR 0.79-1.42). As expected, adult SEP was an important influence on smoking behaviour and obesity. In addition, factors related to disadvantaged social origins appeared to increase the risk of obesity and reduce the probability of quitting smoking in adulthood, particularly in women.
Article
Full-text available
We assessed the associations of childhood socioeconomic position with cardiovascular disease risk factors (smoking, binge alcohol drinking, and being overweight) and examined the roles of educational attainment and cognitive functioning in these associations. Data were derived from a cohort study involving 7184 individuals who were born in Aberdeen, Scotland, between 1950 and 1956; had detailed records on perinatal characteristics, childhood anthropometry, and cognitive functioning; and responded to a mailed questionnaire when they were aged 45 to 52 years. Strong graded associations existed between social class at birth and smoking, binge drinking, and being overweight. Adjustment for educational attainment completely attenuated these associations. However, after control for adult social class, adult income and other potential confounding or mediating factors, some association remained. Educational attainment is an important mediating factor in the relation between socioeconomic adversity in childhood and smoking, binge drinking, and being overweight in adulthood.
Article
Full-text available
Although adult reported childhood socioeconomic position has been related to health outcomes in many studies, little is known about the validity of such distantly recalled information. This study evaluated the validity of adults' reports of childhood paternal social class. Data are drawn from the Aberdeen children of the 1950s study, a cohort of 12 150 people born in Aberdeen (Scotland) who took part in a school based survey in 1962. In this survey, two indices of early life socioeconomic position were collected: occupational social class at birth (abstracted from maternity records) and occupational social class in childhood (reported during the 1962 survey by the study participants). Between 2000 and 2003, a questionnaire was mailed to traced middle aged cohort members in which inquiries were made about their fathers' occupation when they were aged 12 years. The level of agreement between these reports and prospectively collected data on occupational social class was assessed. In total, 7183 (63.7%) persons responded to the mid-life questionnaire. Agreement was moderate between social class of father recalled in adulthood and that measured in early life (kappa statistics were 0.47 for social class measured at birth, and 0.56 for social class reported by the child). The relation of occupational social class to birth weight and childhood intelligence was in the expected directions, although weaker for adults' reports in comparison with prospectively gathered data. In studies of adult disease aetiology, associations between childhood social class based on adult recall of parental occupation and health outcomes are likely to underestimate real effects.
Article
The lack of an operational definition for hunger has been frequently cited as a barrier to progress in addressing the problem. The purposes of this research were to develop an understanding of hunger from the perspective of women who had experienced it and to construct and evaluate indicators to measure hunger directly in similar populations. In-depth interviews were conducted with 32 women of childbearing age from rural and urban areas of Upstate New York. Qualitative analysis of the responses yielded a conceptualization of hunger that included two levels: the individual and household. Hunger at each of these levels had quantitative, qualitative, psychological and social components. These women also viewed hunger as a managed process. Based on this conceptualization of hunger, survey items were developed and evaluated, using data from a questionnaire administered to 189 women from the same geographical area. Three scales, one each for household, women's, and children's hunger, emerged and were found to be valid and reliable indicators for measuring hunger directly in this population.
Book
Most writing on sociological method has been concerned with how accurate facts can be obtained and how theory can thereby be more rigorously tested. In The Discovery of Grounded Theory, Barney Glaser and Anselm Strauss address the equally Important enterprise of how the discovery of theory from data--systematically obtained and analyzed in social research--can be furthered. The discovery of theory from data--grounded theory--is a major task confronting sociology, for such a theory fits empirical situations, and is understandable to sociologists and laymen alike. Most important, it provides relevant predictions, explanations, interpretations, and applications. In Part I of the book, "Generation Theory by Comparative Analysis," the authors present a strategy whereby sociologists can facilitate the discovery of grounded theory, both substantive and formal. This strategy involves the systematic choice and study of several comparison groups. In Part II, The Flexible Use of Data," the generation of theory from qualitative, especially documentary, and quantitative data Is considered. In Part III, "Implications of Grounded Theory," Glaser and Strauss examine the credibility of grounded theory. The Discovery of Grounded Theory is directed toward improving social scientists' capacity for generating theory that will be relevant to their research. While aimed primarily at sociologists, it will be useful to anyone Interested In studying social phenomena--political, educational, economic, industrial-- especially If their studies are based on qualitative data.
Article
This study of women with children in a rural county of upstate New York examined the relationships of food insecurity and income with two nutritional consequences (adiposity and fruit and vegetables consumption), and assessed whether disordered eating patterns is a mediator for the effects of food insecurity and income on these nutritional consequences. Each of 193 respondents was interviewed twice in her home. Data were collected on household food stores, socioeconomic and demographic characteristics, methods of obtaining food, food program participation, household expenditures, food intake, the Radimer/Cornell hunger and food insecurity items, height, weight, frequency of fruit and vegetable consumption, and disordered eating patterns. Regression analysis was used to analyze the relationships of body mass index and an obesity classification with height, income, education, single parenthood, employment, food insecurity, disordered eating, and frequency of fruit and vegetable consumption. Regression analysis was also used to examine the relationships of disordered eating and frequency of fruit and vegetable consumption with the other variables. Lower income and unemployment were related to higher adiposity. The effects of income on adiposity were not mediated through disordered eating patterns or through fruit and vegetable consumption. Food insecurity was related to adiposity, and part of this effect of food insecurity was mediated through disordered eating. This mediating effect of disordered eating partially explained why those experiencing the least severe food insecurity were more likely to be overweight than those who were food secure, but those experiencing the most severe food insecurity were less likely to be overweight than those who were food secure. Food insecurity was related to lower fruit and vegetable consumption, but this did not translate into effects on adiposity.
Article
The association of various features of family life with obesity in childhood is well established, but less is known about the effect of these influences on the risk of later obesity. In this prospective, population-based study, we examined the influence of parental care in childhood on the risk of obesity in the offspring in young adulthood. In 1974, 1258 pupils aged 9-10 years were randomly selected from the third grade of Copenhagen schools. Information on 987 pupils was obtained from the form teachers on family structure and the perceived support from the parents; school medical services reported on the child's general hygiene. 756 (86%) of the 881 eligible participants were followed up 10 years later. The influence of family factors in childhood on the risk of obesity (body-mass index > 95th centile) in young adulthood was estimated by odds ratios with control for age and body-mass index in 1974, sex, and social background. Family structure (biological or other parents and number of siblings) did not significantly affect the risk of adult obesity. Parental neglect greatly increased the risk in comparison with harmonious support (odds ratio 7.1 [95% CI 2.6-19.3]). Dirty and neglected children had a much greater risk of adult obesity than averagely groomed children (9.8 [3.5-28.2]). However, being an only child, receiving overprotective parental support, or being well-groomed had no effect. Parental neglect during childhood predicts a great risk of obesity in young adulthood, independent of age and body-mass index in childhood, sex, and social background.
Article
A review of the literature and research on food restriction indicates that inhibiting food intake has consequences that may not have been anticipated by those attempting such restriction. Starvation and self-imposed dieting appear to result in eating binges once food is available and in psychological manifestations such as preoccupation with food and eating, increased emotional responsiveness and dysphoria, and distractibility. Caution is thus advisable in counseling clients to restrict their eating and diet to lose weight, as the negative sequelae may outweigh the benefits of restraining one's eating. Instead, healthful, balanced eating without specific food restrictions should be recommended as a long-term strategy to avoid the perils of restrictive dieting.
Article
This paper explores how food insecurity and hunger relate to health and nutrition outcomes in food-rich countries such as the United States. It focuses on two subgroups of the population for whom data are available: women of childbearing age and school-age children. Special consideration is given to examining how food insecurity relates to these outcomes independently of socioeconomic status and poverty. In a population-based sample of women of childbearing age, the least severe level of food insecurity (household food insecurity) was correlated with higher body mass index (BMI), controlling for other available and known influences on obesity including income level. In low income school-age children from two large urban areas of the U.S., risk of hunger and hunger were associated with compromised psychosocial functioning, controlling for maternal education and estimated household income. The nutrition and health consequences of food insecurity comprise a potentially rich area for future, socially relevant research in the field of nutritional sciences.
Article
The purpose of this study was to develop an understanding of body weight from emic perspectives of limited-income overweight and obese white women. In-depth individual interviews, including the use of contour drawings and body dissatisfaction parameters. All methods were conducted in the homes of the research participants. A purposeful sample of limited-income white women (N=25), ages 19 to 44 years. Personal perceptions of attractiveness, health, body weight, and body dissatisfaction. Transcripts were analyzed using content analysis. Triangulation of data was achieved by comparing data elicited by different methods in different sections of the interview. Disordered eating habits were common and considered consequences of social, economic, and familial pressures. Food was often used as a means of coping with life pressures. Social and economic barriers were identified as impeding the adoption of more healthful lifestyles. Weight loss was a low priority owing to financial, emotional, familial, and health care constraints. Multidisciplinary programs addressing financial, emotional, and nutritional concerns may be the most effective for weight management among white limited-income women. Additional research is necessary to verify the results of this study with larger samples.
Article
Food insecurity, the limited or uncertain availability of nutritionally adequate and safe foods, may be associated with disordered eating and a poor diet, potentially increasing risk for obesity and health problems. Patterns of food insecurity in California women are described and relationships between food insecurity and obesity (body mass index > or = 30 kg/m(2)) are evaluated using data from the 1998 and 1999 California Women's Health Survey. A total of 8169 women aged > or = 18 y were randomly selected and interviewed by telephone. Food insecurity was evaluated by use of four questions adapted from the U.S. Household Food Security Module. Logistic regression was used to examine the relationship between food insecurity and obesity, controlling for income, race/ethnicity, education, country of birth, general health status and walking. Food insecurity without hunger affected 13.9% of the population and food insecurity with hunger, 4.3%. Almost one fifth (18.8%) of the population was obese. Obesity was more prevalent in food insecure (31.0%) than in food secure women (16.2%). Food insecurity without hunger was associated with increased risk of obesity in whites [odds ratio (OR) = 1.36] and others (OR = 1.47). Food insecurity with hunger was associated with increased risk of obesity for Asians, Blacks and Hispanics (OR = 2.81) but not for non-Hispanic Whites (OR = 0.82). Food insecurity is associated with increased likelihood of obesity and risk is greatest in nonwhites.
Article
The present studies examined if materialists have an elevated concern about food availability, presumably stemming from a general survival security motivation. Study 1 found that materialists set a greater life goal of food security, and reported more food insecurity during their childhood. Materialists reported less present-day food insecurity. Study 2 revealed that materialists stored/hoarded more food at home, and that obese persons endorsed materialism more than low/normal weight persons. Study 3 found that experimentally decreasing participants' feelings of survival security (via a mortality salience manipulation) led to greater endorsement of materialism, food security as goal, and using food for emotional comfort. The results imply that materialists overcame the food insecurity of their childhood by making food security a top life goal, but that materialists' current concerns about food security may not wholly stem from genuine threats to their food supply.
Article
Body weight is inversely related to socioeconomic status (SES) in women in the United States (U.S.). Reasons for the social differential in weight are poorly understood. This investigation sought to understand overweight and obesity from the perspective of low-income mothers living in rural New York State, focusing in particular on challenges to maintaining a healthy weight that may be unique to rural poverty. In-depth interviews with 28 women, who were interviewed 3 times over a 3-year period, were audiotaped, transcribed, and analyzed using the constant comparative method. Findings suggest that transportation difficulties confined some women to their homes, which were physical settings offering little opportunity for physical activity. Food insecurity and associated fluctuating household food supplies contributed to disordered eating patterns and to perceptions of dietary deprivation that affected food intake. Rural isolation contributed to negative emotional states that some women alleviated by eating. This research elucidates factors contributing to obesity among rural, economically disadvantaged women, highlighting the interplay between the structural constraints imposed by rural poverty and women's physical activity, eating patterns, body image, and weight. These insights further the understanding of social inequalities in health and could inform the design of future research aimed at improving the health status of low-income women and families.
Article
this report is a companion volume. The purpose of this report is to describe the analyses through which the food security scales and food security status variable were developed, as well as related tests of the reliability and validity of these measures.
Qualitative data analysis: An expanded sourcebook Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults—The evidence report
  • M B Miles
  • A M Huberman
Miles, M. B., & Huberman, A. M. (1994). Qualitative data analysis: An expanded sourcebook. Thousand Oaks, CA: Sage Publications. National Heart, Lung, and Blood Institute. (1998). Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults—The evidence report. Obesity Research, 6(suppl. 2), 51S–209S.
Research design: Qualitative, quantitative, and mixed method approaches Thousand Oaks Nutritional consequences of food insecurity in a rural New York State county. Discussion Paper no. 1120-97
  • J W Creswell
  • E A Frongillo Jr
  • C M Olson
  • B S Rauschenbach
  • A Kendall
Creswell, J. W. (2003). Research design: Qualitative, quantitative, and mixed method approaches (2nd ed). Thousand Oaks: Sage Publications. Frongillo Jr., E. A., Olson, C. M., Rauschenbach, B. S., & Kendall, A. (1997). Nutritional consequences of food insecurity in a rural New York State county. Discussion Paper no. 1120-97. Madison, WI: Institute for Research on Poverty, University of Wisconsin-Madison.
Eating disorders: Management of obesity, bulimia and anorexia nervosa
  • W S C M Agras
  • Olson
Agras, W. S. (1987). Eating disorders: Management of obesity, bulimia and anorexia nervosa. New York: Pergamon Press. ARTICLE IN PRESS C.M. Olson et al. / Appetite 49 (2007) 198–207
Growing overweight and obesity in America: the potential role of Federal nutrition programs Guide to measuring household food security, revised 2000 Obesity in low-income rural women
  • D Besharov
  • G Bickel
  • M Nord
  • C Price
  • W Hamilton
  • J Cook
Besharov, D. (2003). Growing overweight and obesity in America: the potential role of Federal nutrition programs. Testimony before the Senate Committee on Agriculture, Nutrition and Forestry, 3 April 2003. Bickel, G., Nord, M., Price, C., Hamilton, W., & Cook, J. (2000). Guide to measuring household food security, revised 2000. Alexandria, VA: US Department of Agriculture, Food and Nutrition Service. Bove, C. F., & Olson, C. M. (2006). Obesity in low-income rural women: Qualitative insights about physical activity and eating patterns.
The food insecurity-obesity paradox. Final Report submitted to USDA ERS Small Grants Program at UC-Davis
  • C M Olson
  • M S Strawderman
Olson, C. M., & Strawderman, M. S. (2004). The food insecurity-obesity paradox. Final Report submitted to USDA ERS Small Grants Program at UC-Davis.
Growing overweight and obesity in America: the potential role of Federal nutrition programs. Testimony before the Senate Committee on Agriculture
  • D Besharov
Guide to measuring household food security
  • G Bickel
  • M Nord
  • C Price
  • W Hamilton
  • J Cook
Child to adult socioeconomic conditions and obesity in a national cohort
  • Power