A systematic review examining the relationship between food insecurity and early childhood physiological health outcomes

Abstract

Food insecurity, or limited access to nutritious foods, is a significant public health concern especially among vulnerable populations including infants and young children in low-income households. While literature to date has thoroughly examined the psychological and behavioral impacts of food insecurity on children, no known study to date has specifically synthesized the literature exploring the relationship between food insecurity and physiological health outcomes during early childhood. The purpose of this study was to review the literature on physiological health outcomes associated with food insecurity during early childhood among children aged 0–5 years in developed countries. Our literature search sources included PubMed, PsycInfo, CINAHL, and Embase databases. A total of 657 articles published up to September 2019 were reviewed for eligibility by two coders, with a third reviewer in cases of disagreement. Eighty-three articles remained after screening by abstract, with a final 27 studies ultimately included in the final synthesis. This review is registered with PROSPERO and adhered to PRISMA guidelines. In total, 20 articles (74%) noted significant relationships between food insecurity and physiological health outcomes in young children. Findings included an association with overweight or obesity (n = 9), anemia (n = 3), poor child health (n = 3), low birth weight (n = 3), chronic illness (n = 1), special health care needs (n = 1), and increased cortisol (n = 1), in young children who experience food insecurity. Identifying relationships between food insecurity and health outcomes during early childhood has the potential to inform future prevention interventions to reduce health disparities in these vulnerable populations.

Examining Associations Between Food Insecurity, Inhibitory Control, and Body Mass Index in Preschoolers

“…6 In addition, they contribute to a growing body of literature suggesting that the relation between food insecurity and BMI may be more nuanced depending on the conceptualization of food insecurity, as evidenced by the significant interactions in both models. 16 Ultimately, these findings provide a more refined understanding of the conditions under which food insecurity affects BMI.…”

“…15 Meanwhile, a recent meta-analysis found significant relations between food insecurity and overweight or obesity among children aged 0 to 5 years in only half of the studies in their sample, with variation by child sex, ethnicity, and conceptualization of food insecurity. 16 Researchers have speculated that the contradictory findings in the literature may be explained by whether the measurement of food insecurity is at the child level or household level. 6 Specifically, parents may protect their children from food insecurity, thus leading to discrepancies of experiences between children and adults in the same household.…”

“…23 Covariates Child age in years, sex (female 5 1), race/ethnicity, group (1 5 participation in the high-quality prekindergarten program), parent monthly income, partner status (1 5 parent living with a partner), parent education level, and number of children in the home were used as control variables in all analyses because of their connections with the primary study variables. 1,4,8,16 Parent education was assessed by asking the parent to report their highest level of education, and indicator variables were created for each category: less than high school, high school diploma, some college, and college degree (reference group). Parents reported on children's race/ethnicity, and indicator variables were created for each category: Black/African-American, Latinx, mixed/others, and White/Caucasian (reference group).…”

Impact of coronavirus disease 2019 on food security in early childhood

“…Food insecurity contributes to the “double burden of malnutrition” and can lead to both undernutrition [ 18 ] and child obesity [ 19 ], as it is linked to unhealthy eating habits [ 20 ], including reduced fruit and vegetable intake [ 21 ] and a higher likelihood of consuming sugar-sweetened beverages [ 22 ]. In addition, food insecurity during childhood is associated with poor health outcomes, including higher risk of anemia, chronic illness, and hospitalizations [ 23 ], as well as social and emotional problems [ 24 , 25 ] and impaired academic success [ 25 , 26 ].…”

Intersection of food insecurity and moral experiences of those involved in paediatric healthcare: A scoping review of child, caregiver and healthcare provider perspectives

“…Extensive literature reports upon the associations between FI and a wide range of deleterious child health and development outcomes (De Oliveira et al, 2020; Gallegos et al, 2021; Shankar et al, 2017; Simonovich et al, 2020). FI is also related to worse general child health, increased likelihood of experiencing acute and chronic health conditions such as asthma, eczema or depressive symptoms, increased emergency department use among children and higher likelihood of delaying medical care because of cost (Thomas et al, 2019).…”