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Building a Stronger Montana. The Impact of Food I nsecurity on Growth, Obesity and Chronic Disease Leah M.K. Anderson, MD . Food insecurity in children Short-term health C hronic disease Mental health Obesity. Food insecure children a re m ore likely to be in poor h ealth.
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Building a Stronger Montana The Impact of Food Insecurity on Growth, Obesity and Chronic Disease Leah M.K. Anderson, MD
Food insecurity in children Short-term health Chronic disease Mental health Obesity
Food insecure children are more likely to have chronic disease
Food Insecurity and Chronic Disease • Associated with • diabetes • heart disease • Children experiencing hunger are more likely to experience • lower physical functioning (Casey, 2005) • more frequent stomachaches and headaches (Alaimo, 2001)
Food Insecurity and Mental Disease • Increased depression • Increase anxiety (Weinreb 2002) • Increased suicidal tendencies (Alaimo, 2002)
Food insecure children are more likely to be overweight or obese
Food Insecurity and Obesity • Study of 6,500 children • food insecurity was positively associated with overweight and obesity in those 12 to 19 years of age. (Townsend & Melgar-Quinonez, 2003) • National sample of almost 7,000 children • childhood food insecurity was associated with overweight. (Casey 2005) • A three-city study (Boston, San Antonio, and Chicago) of 1,011 adolescents • maternal stress in combination with adolescent food insecurity significantly increased adolescent’s probability of being overweight or obese. (Lohman, 2009)
Food Insecurity and Obesity • National sample of 8,693 infants and toddlers • indirect association between food insecurity and overweight that operated through parenting practices and infant feeding practices. (Bronte-Tinkew, 2007) • Among 2- 5-year-old girls – but not boys – in Massachusetts participating in WIC • food insecure homes had 47 percent higher odds of being obese compared to those from food secure homes. (Metallinos-Katsaras, 2009)
Food Insecurity and Obesity • How does this occur? • Limited resources • Lack of access to healthy, affordable foods • Fewer opportunities for physical activity • Cycles of food deprivation and overeating • Chronic deprivation leads to neuro-chemical changes that increase reward effect of food even when food later becomes plentiful • Increased drive for energy-dense foods • High levels of stress • Stress hormones can further drive power of food reward • Greater exposure to marketing of obesity-promoting products • Limited access to health care
Conclusions • Food insecurity has real effects on well-being of children and adults • Children who are food insecure are more likely to experience chronic mental and physical health problems • Food insecurity is bimodal – representing both under-consumption as well as mal-consumption • Chronic stress of real (or perceived) food deprivation can alter power and nature of food-desire
References • Cook, J. T., Frank, D. A., Berkowitz, C., Black, M. M., Casey, P. H., Cutts, D. B., ... & Nord, M. (2004). Food insecurity is associated with adverse health outcomes among human infants and toddlers. The Journal of nutrition, 134(6), 1432-1438. • Casey, P. H., Szeto, K. L., Robbins, J. M., Stuff, J. E., Connell, C. , Gossett, J. M., & Simpson, P. M. (2005). Child health- related quality of life and household food security. Archives of Pediatrics and Adolescent Medicine, 159(1), 51- 56. • Alaimo, K., Olson, C. M., Frongillo, E. A. Jr., & Briefel, R. R. (2001). Food insufficiency, family income, and health in U.S. preschool and school-aged children. American Journal of Public Health, 91(5), 781-786. • Seligman, H. K., Bindman, A. B., Vittinghoff, E., Kanaya, A. M., & Kushel, M. B. (2007). Food insecurity is associated with diabetes mellitus: Results from the National Health Examination and Nutrition Examination Survey (NHANES) 1999–2002. Journal of General Internal Medicine, 22(7), 1018-1023. • Seligman, H. K., Laraia, B. A., & Kushel, M. B. (2010). Food insecurity is associated with chronic disease among low- income NHANES participants. Journal of Nutrition, 140(2), 304-310. • Siefert, K., Heflin, C. M., Corcoran, M. E., & Williams, D. R. (2004). Food insufficiency and physical and mental health in a longitudinal survey of welfare recipients. Journal of Health and Social Behavior, 45(2), 171-186. • Weinreb, L., Wehler, C., Perloff, J., Scott, R., Hosmer, D., Sagor, L., & Gundersen, C. (2002). Hunger: its impact on children's health and mental health. Pediatrics, 110, e41 • Alaimo, K., Olson, C. M., & Frongillo, E. A. (2002). Family food insufficiency, but not low family income, is positively associated with dysthymia and suicide symptoms in adolescents. Journal of Nutrition, 132, 719−725. • Townsend, M. & Melgar-Quinonez, H. (2003). Hunger, food insecurity, and child obesity. Food Assistance and Nutrition Research Report, 38. Washington, DC: U.S. Department of Agriculture, Economic Research Service. • Lohman, B. J., Stewart, S., Gundersen, C., Garasky, S., & Eisenmann, J. C. (2009). Adolescent overweight and obesity: links to food insecurity and individual, maternal, and family stressors. Journal of Adolescent Health, 45(3), 230-237. • Bronte-Tinkew, J., Zaslow, M., Capps, R., Horowitz, A., & McNamara, M. (2007). Food insecurity works through depression, parenting, and infant feeding to influence overweight and health in toddlers. Journal of Nutrition, 137(9), 2160-2165. • Metallinos-Katsaras, E., Sherry, B., & Kallio, J. (2009). Food insecurity is associated with overweight in children younger than 5 years of age. Journal of the American Dietetic Association, 109(10), 1790-1794