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A pilot investigation of food insecurity among children seen in an outpatient pediatric nephrology clinic.

ABSTRACT: Food insecurity (FI) is common - affecting one in six American households with children. FI is defined as limited or uncertain availability of nutritionally adequate and safe foods. Awareness of food insecurity and its impact on health has increased since the American Academy of Pediatrics 2015 policy statement, "Promoting Food Security for All Children." Though FI is frequently addressed in general pediatric primary care, it is not routinely identified in patients with chronic medical problems. Patients with complex care needs, prescription medication, or restrictive nutritional requirements may be at higher risk of food insecurity. The prevalence of FI in patients with chronic disease, including pediatric patients with kidney disease, remains unknown. We sought to determine the prevalence of FI among our pediatric nephrology clinic patients with a cross-sectional screening pilot study. Nearly 35% of 118 children seen in our pediatric nephrology outpatient clinic lived in food insecure households, a prevalence rate more than double the general pediatric population (16%). Barriers to food security were variable; common themes included challenges with restricted diet and available food, identifying and accessing community resources, and not qualifying for support. For physicians, dietitians, and other health providers that counsel patients with kidney disease on dietary interventions, it is important to be aware of food security status. To our knowledge, this is the first study to assess the prevalence of food insecurity in pediatric patients with kidney disease. Further studies of food insecurity and social determinants of heath in this patient population are needed.

SUBMITTER: Starr MC

PROVIDER: S-EPMC5966523 | biostudies-literature | 2018 Jun

REPOSITORIES: biostudies-literature

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A pilot investigation of food insecurity among children seen in an outpatient pediatric nephrology clinic.

Starr Michelle C MC Fisher Kelly K Thompson Kirsten K Thurber-Smith Kathryn K Hingorani Sangeeta S

Preventive medicine reports 20180302

Food insecurity (FI) is common - affecting one in six American households with children. FI is defined as limited or uncertain availability of nutritionally adequate and safe foods. Awareness of food insecurity and its impact on health has increased since the American Academy of Pediatrics 2015 policy statement, "Promoting Food Security for All Children." Though FI is frequently addressed in general pediatric primary care, it is not routinely identified in patients with chronic medical problems. ...[more]

PMID: 29850396

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Project description:Food insecurity, vitamin D deficiency and lower respiratory tract infections are highly prevalent conditions among Inuit children. However, the relationship between these conditions has not been examined in this population.The objective of this study was to examine the relationship between food insecurity and severe respiratory infections before age 2 years and health centre visits for a respiratory problem in the past year. We also explored the relationship between serum vitamin D status and respiratory outcomes in this population.We included children aged 3-5 years who participated in a cross-sectional survey of the health of preschool Inuit children in Nunavut, Canada, from 2007 to 2008 (n=388). Parental reports of severe respiratory infections in the first 2 years of life and health care visits in the past 12 months were assessed through a questionnaire. Child and adult food security were assessed separately and serum 25-hydroxyvitamin D3 levels were measured in a subgroup of participants (n=279). Multivariate logistic regression was performed to assess the association between food security, vitamin D and each of the 2 respiratory outcomes.Child and adult food insecurity measures were not significantly associated with adverse respiratory outcomes. Household crowding [odds ratio (OR)=1.51, 95% confidence interval (CI) 1.09-2.09, p=0.01 for the child food security model] and higher birth weight (OR=1.21, 95% CI: 1.02-1.43, p=0.03) were associated with reported severe chest infections before age 2 years while increasing age was associated with decreased odds of reported health care visits for a respiratory problem (OR=0.66, 95% CI: 0.48-0.91, p=0.02). Neither vitamin D insufficiency nor deficiency was associated with these respiratory outcomes.Using a large cross-sectional survey of Inuit children, we found that household crowding, but not food security or vitamin D levels, was associated with adverse respiratory outcomes. Further studies are warranted to examine the impact of decreasing household crowding on the respiratory health of these children.

Dataset Information

A pilot investigation of food insecurity among children seen in an outpatient pediatric nephrology clinic.

Publications

A pilot investigation of food insecurity among children seen in an outpatient pediatric nephrology clinic.

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