Dataset Information

Timing of household food insecurity exposures and asthma in a cohort of US school-aged children.

ABSTRACT:

Objective

Food insecurity is positively associated with asthma, the most common chronic childhood disease, yet directionality is unclear. The objective was to determine the association between exposure to food insecurity in early childhood and the odds of asthma later in childhood.

Design

Data from four waves of the Early Childhood Longitudinal Study-Kindergarten (ECLS-K) cohort, a prospective, dual-frame, multistage probability cluster sampling study of school-aged US children were entered in multivariate logistic regression models, adjusted for covariates. Exposures to food insecurity were based on parental responses to the validated USDA 18-item module at each wave.

Setting

Public and private primary and secondary schools between 1998 and 2007.

Participants

At its inception (1999), the ECLS-K had 20?578 kindergarteners; by the spring of eighth grade (2007), the cohort dropped to 9725 due to attrition. Children missing an exposure, outcome or confounding variable were excluded, final n=6731.

Primary outcome measure

Child's diagnosis of asthma by a healthcare professional as reported by the parent.

Results

Household food insecurity (vs food security) in the year before kindergarten and in second grade had a higher odds of asthma by 18% (95% CI 1.17 to 1.20) and 55% (95% CI 1.51 to 1.55). After removing asthmatics before third grade from the model, food insecurity in second grade was associated with higher odds of asthma at fifth or eighth grades (OR 1.55; 95% CI 1.53 to 1.58), whereas food insecurity in the year before kindergarten had a lower odds at fifth or eighth grades.

Conclusions

Food insecurity in the year before kindergarten and in second grade were associated with a higher odds of asthma in third grade. Food insecurity in second grade retained the signal for increased odds of asthma after third and through eighth grades. Additional research is needed to explore childhood windows of vulnerability to asthma.

SUBMITTER: Mangini LD

PROVIDER: S-EPMC6278782 | biostudies-literature | 2019 Feb

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Timing of household food insecurity exposures and asthma in a cohort of US school-aged children.

Mangini Lauren D LD Hayward Mark D MD Zhu Yeyi Y Dong Yongquan Y Forman Michele R MR

BMJ open 20190222 11

<h4>Objective</h4>Food insecurity is positively associated with asthma, the most common chronic childhood disease, yet directionality is unclear. The objective was to determine the association between exposure to food insecurity in early childhood and the odds of asthma later in childhood.<h4>Design</h4>Data from four waves of the Early Childhood Longitudinal Study-Kindergarten (ECLS-K) cohort, a prospective, dual-frame, multistage probability cluster sampling study of school-aged US children we ...[more]

PMID: 30798285

Similar Datasets

Project description:BackgroundChildhood food insecurity has been associated with prevalent asthma in cross-sectional studies. Little is known about the relationship between food insecurity and incident asthma.MethodsWe used administrative databases linked with the Canadian Community Health Survey, to conduct a retrospective cohort study of children <18 years in Ontario, Canada. Children without a previous diagnosis of asthma who had a household response to the Household Food Security Survey Module (HFSSM) were followed until March 31, 2018 for new asthma diagnoses using a validated administrative coding algorithm. We used multivariable Cox proportional hazard models to examine the association between food insecurity and incident asthma, and adjusted models sequentially for clinical and clinical/socioeconomic risk factors. As additional analyses, we examined associations by HFSSM respondent type, severity of food insecurity, and age of asthma diagnosis. Moreover, we assessed for interaction between food security and child's sex, household smoking status, and maternal asthma on the risk of incident asthma.ResultsAmong the 27,746 included children, 5.1% lived in food insecure households. Over a median of 8.34 years, the incidence of asthma was 7.33/1000 person-years (PY) among food insecure children and 5.91/1000 PY among food secure children (unadjusted hazard ratio [HR] 1.24, 95% CI 1.00 to 1.54, p = 0.051). In adjusted analyses associations were similar (HR 1.16, 95% CI 0.91 to 1.47, p = 0.24 adjusted for clinical risk factors, HR 1.24, 95% CI 0.97 to 1.60, p = 0.09 adjusted for clinical/socioeconomic factors). Associations did not qualitatively change by HFSSM respondent type, severity of food insecurity, and age of asthma diagnosis. There was no evidence of interaction in our models.ConclusionsFood insecure children have numerous medical and social challenges. However, in this large population-based study, we did not observe that childhood food insecurity was associated with an increased risk of incident asthma when adjusted for important clinical and socioeconomic confounders.

Dataset Information

Timing of household food insecurity exposures and asthma in a cohort of US school-aged children.

Objective

Design

Setting

Participants

Primary outcome measure

Results

Conclusions

Publications

Timing of household food insecurity exposures and asthma in a cohort of US school-aged children.

Similar Datasets

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