Food Insecurity Is Associated with Obesity among US Adults in 12 States

Abstract

A redesigned food insecurity question that measured food stress was included in the 2009 Behavioral Risk Factor Surveillance System in the Social Context optional module. The objective of our study was to examine the association between food stress and obesity using this question as a surrogate for food insecurity. Our analytic sample included 66,553 adults from 12 states. Food insecurity was determined by response (always/usually/sometimes) to the question,"Howoften in the past 12 months would you say you were worried or stressed about having enough money to buy nutritious meals?" T tests were used to compare prevalence differences between groups, and logistic regression was used to examine the association between food insecurity and obesity. Among the 12 states, the prevalence of obesity was 27.1% overall, 25.2% among food secure adults, and 35.1% among food insecure adults. Food insecure adults had 32% increased odds of being obese compared to food secure adults. Compared with food secure adults, food insecure adults had significantly higher prevalence of obesity in the following population subgroups: adults ages ≥30 years, women, non-Hispanic whites, non-Hispanic blacks, adults with some college education or a college degree, a household income of <$25,000 or $50,000 to $74,999, and adults with none or two children in their households. One in three food insecure adults were obese. Food insecurity was associated with obesity in the overall population and most population subgroups. These findings are consistent with previous research and highlight the importance of increasing access to affordable healthy foods for all adults. Both obesity and food insecurity affect health, which is determined not merely by behavioral, biologic, and genetic factors, but also by a range of environmental and social determinants. 8 These include safe environments, adequate income, meaningful and valued social roles, secure housing, higher levels of education, and social support. 8 HHS Public AccessObesity and food insecurity are more prevalent among low-income populations. 5,8 Food insecure adults may rely on low-cost, high-energy foods, 5 which can lead to overconsumption of energy and result in obesity. In 1995 Dietz 9 proposed a relationship between obesity and hunger, the most severe form of food insecurity, based on a case report; since then, a number of studies [10][11][12][13][14][15] have examined the association between obesity and food insecurity among US adults. However, only two studies 16,17 have tested this relationship using data from the Behavioral Risk Factor Surveillance System (BRFSS). The food insecurity question included in BRFSS during the 1990s asked whether the respondent worries about having enough food for herself/himself or her/his family. A study based on this question found that food insecurity was associated with obesity in Washington State during 1995-1999. 16 In addition, Laraia and colleagues 17 analyzed the 1999 BRFSS data for Louisiana and New York and found that, at that time, self-rep...

Trajectories of Body Mass Index from Young Adulthood to Middle Age among Canadian Men and Women

“…This finding is consistent with previous research that has found that individuals who were food insecure were more likely to be overweight or obese [47,71,72]. It should be noted that much Canadian research investigating food security/insecurity has used the food security module developed for the Canadian Community Health Survey (CCHS) which defines food security/insecurity somewhat differently than the present investigation [73].…”

“…Previous studies found that BMI and/or BMI changes are often linked to gender, age, race/ethnicity, education, and income [12,33,[42][43][44][45]. In addition, food insecurity, place of residence, and lifestyle factors, such as physical activity, smoking, and alcohol use, are all potentially associated with body mass or body mass change [44,[46][47][48][49][50][51]. Covariates can be classified as risk factors (time-invariant) and time-varying covariates.…”

Food Justice: What is it? Where has it been? Where is it going?

“…Because food insecurity implies a lack of access to food, it is most often associated with malnutrition and weight loss. However, research also indicates that reliance on low-quality, energyrich foods can result in overweight or obesity [28], particularly when combined with other socioeconomic or geographic obstacles prevalent in food-insecure areas. For example, people living in these areas often have limited agency over their environments and face barriers to safe outdoor physical activity and the opportunity to purchase and prepare healthful foods [29].…”

“…Many of these focus on at-risk groups such as children, pregnant women, and older adults and revolve around foodborne illness and food safety; measures of food security; environmental issues such as climate change and genetically modified crops; and national and global food aid policies. The concept of food security benefits from the diverse and experimental nature of the literature, particularly given the associations between food insecurity, health status indicators such as obesity and malnutrition, and special interest groups such as immigrants, school children, and mothers [20,28,33].…”

Including the Voices of Communities in Food Insecurity Research: An Empowerment-based Agenda for Food Scholarship

“…There is a need, however, for participatory research that works with residents of food deserts to explore how they understand and respond to their local foodscape and that builds the community's capacity to transform the local food environment. A large number of studies have looked at the effects of food insecurity on the health outcomes of overweight and obesity (Brown et al, 2007;Dinour, Bergen, & Yeh, 2007;Pan, Sherry, Njai, & Blanck, 2012). We question if the particular issue of obesity is a priority to many of the communities experiencing food insecurity.…”