Food insecurity (FI) has been paradoxically associated with childhood obesity. Little research has examined whether FI influences response to childhood obesity treatment.
Conduct a secondary analysis examining effects of household FI status on weight-related outcomes among children participating in a low-intensity obesity treatment program delivered at a federally qualified health center (FQHC).
Study Design, Setting, Participants
Two 6-month family-based programs targeting energy-balance behaviors were implemented. One program targeted caregiver and child behaviors, while the other targeted child behaviors only. Children 4-10 years, body mass index (BMI) ≥85th percentile, receiving integrated primary care at the FQHC, and with a female caregiver were randomized to 1 of the 2 programs. The program consisted of alternating monthly in-person meetings and phone calls delivered by a licensed behaviorist in primary care.
Household FI status at 0 months was determined by the U.S. Household Food Security Module. At months 0 and 6, measured anthropometrics were used to calculate BMI z-score (zBMI), and energy intake (EI) was assessed via three 24-hour dietary recalls. Regression analyses, controlling for randomization and 0-months zBMI or EI, examined if FI status predicted post-intervention zBMI or EI. Repeated measures controlling for the randomized group examined the main effect of time on zBMI and EI.
Sixty-six children (8.2 ± 1.8 years, 59% male, 91% White, 77% Hispanic/Latino, 35% FI) were included in analysis. FI status was not related to zBMI, t(62) = 1.01, P = 0.32, or EI, t(48) = 0.44, P = .66, at post-intervention. A main effect of time was observed for zBMI (2.01 ± 0.42 vs 1.94 ± 0.47), F(1,64) = 5.97, P = .017, and EI (1172 ± 454 kcal vs 1021 ± 196 kcal), F(1,50) = 6.86, P = .012.
FI status did not affect weight-related outcomes in this low-intensity obesity treatment program. Future research should examine whether FI status affects outcomes in more intensive interventions for which adherence may be challenging for families with unstable food access.