Food Insecurity and Childhood Obesity: A Systematic Review

Abstract

BACKGROUND AND OBJECTIVES: Addressing food insecurity while promoting healthy body weights among children is a major public health challenge. Our objective is to examine longitudinal associations between food insecurity and obesity in US children aged 1 to 19 years. METHODS: Sources for this research include PubMed, CINAHL, and Scopus databases (January 2000 to February 2022). We included English language studies that examined food insecurity as a predictor of obesity or increased weight gain. We excluded studies outside the United States and those that only considered the unadjusted relationship between food security and obesity. Characteristics extracted included study design, demographics, methods of food security assessment, and anthropometric outcomes. RESULTS: Literature searches identified 2272 articles; 13 met our inclusion criteria. Five studies investigated the relationship between food insecurity and obesity directly, whereas 12 examined its relationship with body mass index or body mass index z-score. Three studies assessed multiple outcomes. Overall, evidence of associations between food insecurity and obesity was mixed. There is evidence for possible associations between food insecurity and obesity or greater weight gain in early childhood, for girls, and for children experiencing food insecurity at multiple time points. Heterogeneity in study methods limited comparison across studies. CONCLUSIONS: Evidence is stronger for associations between food insecurity and obesity among specific subgroups than for children overall. Deeper understanding of the nuances of this relationship is critically needed to effectively intervene against childhood obesity.

Household food insecurity and its association with childhood overweight and obesity

“…In general, there is controversy in studies regarding the association between HFI and childhood overweight/obesity, although it seems that large cross-sectional studies and systematic reviews have shown a positive association [17,20]. In our study, we found an independent association between the HFI and childhood overweight and obesity.…”

“…Its relationship is controversial and its association is not yet clear. Although numerous studies in developed countries found a positive relationship between HFI and childhood obesity [14][15][16][17] , others did not observe any association [18][19][20], and some detected an inverse association [21].…”

Association of a primary care‐based mobile food pantry with child body mass index: A propensity score matched cohort study

“…The evidence for a causal relationship of household food insecurity with childhood obesity has been mixed, and no studies to date have examined clinically‐based food security interventions on childhood obesity outcomes 18 . This research is the first to demonstrate that a clinical‐community partnership to deliver a mobile food pantry program in a clinical setting may help reduce childhood obesity among a population disproportionately burdened by obesity.…”

“…Given the high and rising prevalence of obesity and household food insecurity among children, effective clinical interventions to reduce childhood obesity in households with food insecurity are needed 13,14 . Alleviating food insecurity may help reduce childhood obesity because household food insecurity has been linked to unhealthy dietary factors and childhood obesity 15–18 …”

Young Child Nutrition: Knowledge and Surveillance Gaps across the Spectrum of Feeding

“…Health inequalities exist throughout the world. In particular, food insecurity affected 14.8% of US households with children in 2020 and has been correlated with childhood obesity [ 53 ]. In the US, toddlers living in households with limited incomes may be supported by US federal government programs, such as Special Supplemental Nutrition Program for Women, Infants, and Children, and Supplemental Nutrition Assistance Program, among others [ 13 ].…”