Dataset Information

Trends in Adiposity and Food Insecurity Among US Adults.

ABSTRACT: Importance:Food insecurity is a pervasive public health issue in the US that is associated with greater body weight. Objective:To examine national trends in food insecurity among US adults from 1999 to 2016 according to surrogate measures of adiposity (body mass index [BMI] and waist circumference [WC]). Design, Setting, and Participants:This cross-sectional study analyzed nationally representative data obtained from nine 2-year cycles (1999 to 2000 through 2015 to 2016) of the National Health and Nutrition Examination Survey in the US. The sample comprised adult survey participants aged 20 years or older. Data analyses were performed from July 1, 2019, to March 31, 2020. Main Outcomes and Measures:The primary outcome was food insecurity. Data on BMI (calculated as weight in kilograms divided by height in meters squared) were categorized as follows: normal weight (BMI, <25), overweight (BMI, 25-29.9), and obese (BMI, ?30). Data on WC were categorized as follows: less high risk (men: ?102 cm; women: ?88 cm) or high risk (men: >102 cm; women: >88 cm). Food insecurity prevalence by adiposity was further analyzed using key demographic characteristics, including sex and race/ethnicity (non-Hispanic White, non-Hispanic Black, Hispanic, and Other). Results:Among the 46?145 adults in the final sample, the mean (SD) age was 46.9 (0.2) years. Of this sample, 23?957 were women (52.0%; 95% CI, 51.6%-52.5%) and 20?825 were non-Hispanic White adults (68.8%; 95% CI, 66.6%-71.0%). The estimated prevalence of food insecurity was 18.2% (95% CI, 15.3%-21.2%) in the 2015 to 2016 cycle, a statistically significant change from 8.7% (95% CI, 7.3%-10.2%) in the 1999 to 2000 cycle. Among all adiposity categories, food insecurity prevalence significantly increased from the 1999 to 2000 cycle to the 2015 to 2016 cycle. The prevalence of food insecurity was highest in adults with obesity (22.6%; 95% CI, 19.5%-25.8%; P for trend <.001). For both men and women, food insecurity prevalence significantly increased from the 1999 to 2000 cycle (men: 8.8% [95% CI, 6.9%-10.6%]; women: 8.7% [95% CI, 7.0%-10.5%]) to the 2015 to 2016 cycle (men: 17.2% [95% CI, 14.1%-20.2%]; women: 19.2% [95% CI, 16.2%-22.2%]; P for trends <.001). For non-Hispanic White and non-Hispanic Black adults, food insecurity prevalence increased from the 1999 to 2000 cycle (non-Hispanic White: 6.0% [95% CI, 4.0%-8.0%]; non-Hispanic Black: 12.4% [95% CI, 9.6%-15.2%]) to the 2015 to 2016 cycle (non-Hispanic White: 13.0% [95% CI, 9.8%-16.3%]; non-Hispanic Black: 29.1% [95% CI, 24.2%-34.0%]; P for trends <.001). For Hispanic adults, food insecurity prevalence significantly increased in those with obesity (1999-2000: 19.1% [95% CI, 12.0%-26.1%]; 2015-2016: 37.6% [95% CI, 33.7%-41.5%]; P for trend ?.001) and in both less-high-risk WC (1999-2000: 19.6% [95% CI, 12.8%-26.4%]; 2015-2016: 32.5% [95% CI, 27.3%-37.7%]; P for trend?=?.02) and high-risk WC categories (1999-2000: 19.3% [95% CI, 12.7%-25.9%]; 2015-2016: 36.7% [95% CI, 31.7%-41.7%]; P for trend <.001). Conclusions and Relevance:In this cross-sectional study, the estimated prevalence of food insecurity appeared to increase from 1999 to 2016 and across all levels of adiposity. These results suggest the need for multidisciplinary approaches to address the association between food insecurity and obesity in the US.

SUBMITTER: Myers CA

PROVIDER: S-EPMC7414390 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature

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Trends in Adiposity and Food Insecurity Among US Adults.

Myers Candice A CA Mire Emily F EF Katzmarzyk Peter T PT

JAMA network open 20200803 8

<h4>Importance</h4>Food insecurity is a pervasive public health issue in the US that is associated with greater body weight.<h4>Objective</h4>To examine national trends in food insecurity among US adults from 1999 to 2016 according to surrogate measures of adiposity (body mass index [BMI] and waist circumference [WC]).<h4>Design, setting, and participants</h4>This cross-sectional study analyzed nationally representative data obtained from nine 2-year cycles (1999 to 2000 through 2015 to 2016) of ...[more]

PMID: 32766803

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Project description:Background/objectivesFood insecurity has emerged as a critical health issue for older adults. Food insecurity has been shown to disrupt healthy eating patterns, but these associations have not been widely studied among older adults. The objectives of the present study were to: (1) examine national trends in food insecurity across a 10-year period, and (2) evaluate the associations between food insecurity and multiple diet quality indices in a recent and nationally representative sample of adults aged 60 or older.DesignCross-sectional analysis of the 2007-2016 National Health and Nutrition Examination Surveys.SettingNationally representative sample of the United States.ParticipantsThe analytic sample was comprised of 5,097 adults aged 60 or older, with household incomes at or below 300% of the federal poverty level.MeasurementsHousehold food security was measured using the 18-item US Household Food Security Survey Module. Diet was assessed using two 24-hour dietary recalls. Multivariate linear and logistic regression models examined the associations between household food security and three evidence-based diet quality indices, adjusting for sociodemographic and health characteristics.ResultsAcross the 10-year period, food insecurity increased significantly from 5.5% to 12.4% among older adults; this increase was more pronounced among lower-income older adults. From the linear regression models, food insecurity was associated with lower scores on the Healthy Eating Index (β = -1.90, 95% confidence interval (CI) = -3.70, -0.09), the Alternate Healthy Eating Index-2010 (β = -1.47, 95% CI = -2.51, -0.44), and the Mediterranean Diet Score (β = -0.54, 95% CI = -1.06, -0.01) after multivariate adjustment. Further adjustment for the presence of chronic medical conditions did not attenuate these results.ConclusionFood insecurity is associated with lower overall diet quality among older adults, supporting the need for clinical efforts to identify those at risk of food insecurity and public health efforts to alleviate food insecurity and promote healthy eating behaviors among older adults.

Project description:BackgroundFood insecurity, the uncertain ability to access adequate food, can limit adherence to dietary measures needed to prevent and manage cardiometabolic conditions. However, little is known about temporal trends in food insecurity among those with diet-sensitive cardiometabolic conditions.MethodsWe used data from the Continuous National Health and Nutrition Examination Survey (NHANES) 2005-2012, analyzed in 2015-2016, to calculate trends in age-standardized rates of food insecurity for those with and without the following diet-sensitive cardiometabolic conditions: diabetes mellitus, hypertension, coronary heart disease, congestive heart failure, and obesity.Results21,196 NHANES participants were included from 4 waves (4,408 in 2005-2006, 5,607 in 2007-2008, 5,934 in 2009-2010, and 5,247 in 2011-2012). 56.2% had at least one cardiometabolic condition, 24.4% had 2 or more, and 8.5% had 3 or more. The overall age-standardized rate of food insecurity doubled during the study period, from 9.06% in 2005-2006 to 10.82% in 2007-2008 to 15.22% in 2009-2010 to 18.33% in 2011-2012 (p for trend < .001). The average annual percentage change in food insecurity for those with a cardiometabolic condition during the study period was 13.0% (95% CI 7.5% to 18.6%), compared with 5.8% (95% CI 1.8% to 10.0%) for those without a cardiometabolic condition, (parallelism test p = .13). Comparing those with and without the condition, age-standardized rates of food insecurity were greater in participants with diabetes (19.5% vs. 11.5%, p < .0001), hypertension (14.1% vs. 11.1%, p = .0003), coronary heart disease (20.5% vs. 11.9%, p < .001), congestive heart failure (18.4% vs. 12.1%, p = .004), and obesity (14.3% vs. 11.1%, p < .001).ConclusionsFood insecurity doubled to historic highs from 2005-2012, particularly affecting those with diet-sensitive cardiometabolic conditions. Since adherence to specific dietary recommendations is a foundation of the prevention and treatment of cardiometabolic disease, these results have important implications for clinical management and public health.

Dataset Information

Trends in Adiposity and Food Insecurity Among US Adults.

Publications

Trends in Adiposity and Food Insecurity Among US Adults.

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