Holben DH, Taylor CA. Food Insecurity and Its Association With Central Obesity and Other Markers of Metabolic Syndrome Among Persons Aged 12 to 18 Years in the United States. J Am Osteopath Assoc 2015;115(9):536–543. doi: 10.7556/jaoa.2015.111.
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Context: Food insecurity is a preventable health threat and may precipitate central obesity and metabolic syndrome in children and adolescents in the United States.
Objective: To examine (1) health by household food security status; and (2) differences and prevalence of central obesity among persons aged 12 to 18 years in the United States.
Methods: The National Health and Nutrition Examination Survey was administered to a cross-sectional sample of persons aged 12 to 18 years in 1999 to 2006. Controlling for age, race/ethnicity, and sex differences in mean obesity and chronic disease factors across levels of food insecurity (analysis of covariance [Bonferroni post hoc] and ORs [logistic regression analyses]) were examined, as were differences in the rates of risk factors (χ2 statistics).
Results: A total of 7435 participants were analyzed. Those from marginally food secure (n=751) and low–food secure (n=1206) (population size estimate, 26,714,182) households were significantly more likely than their high–food secure counterparts (n=4831) to be overweight (P=.036) (OR, 1.44), and those from marginally food secure households were 1.3-times more likely to be obese (P=.036). Nearly 25% of respondents from marginally food secure, low–food secure, and very low–food secure (n=647) households reported central obesity (P=.002), which was 1.4 to 1.5 times more likely than those from high–food secure households. Participants from high–food secure households had significantly higher mean high-density lipoprotein values (P=.019). Risk factors indicative of metabolic syndrome were present in 3.1%.
Conclusion: Household food insecurity was associated with an increased likelihood of being overweight and having central obesity. Limitations included the use of cross-sectional data and some self-reported data and the inability to control for all moderating variables in obesity and overall health status.
a Data are given as mean (95% CI) unless otherwise indicated. Nonoverlapping CIs represent significant differences (P<.05).
b Percent of age- and sex-specific threshold criteria for the waist circumference risk factor.
Abbreviations: BMI, body mass index; LDL, low-density lipoprotein; HDL, high-density lipoprotein.
a High food security serves as the reference group to which the other groups are compared for likelihood to present with the risk factor.
b Overweight was defined as greater than or equal to 85th percentile and obesity was defined as greater than 95th body mass index–for-age percentile.
Abbreviation: HDL, high-density lipoprotein.
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