Associations between Adult Food Insecurity and Various Nutrition Outcome

Abstract

The purpose of this dissertation is to provide a better understanding of the health and nutritional status of food insecure persons in the United States. This dissertation covers three studies which used data from the National Health and Nutrition Examination Surveys 1999-2002. The first study determined the associations between adult food insecurity and percent body fat (%BF), BMI and height, and %BF and BMI stratified by height. Bioelectrical impedance analysis was used to determine percent body fat for 2,117 men and 1,909 women. Results showed that, among men, %BF, height and BMI decreased as food insecurity (FI) increased. Marginal food security among women who were below median height associated with about 2.0 kg/m2 increase in BMI compared with their fully food secure counterparts, P = 0.042. Marginal food security among women associated with 1.3 cm decrease in height, P = 0.016. Percent body fat did not associate with food insecurity among women irrespective of height. The second study determined the associations between adult food insecurity and body weight change among 2,626 men and 2,685 women in 1 and 10 years using different specifications. Results showed that compared with the fully food secure, food insecurity among women associated with significant weight gain at both the >5kg and >10kg specifications in both 1 and 10 years. Food insecurity associated with higher prevalence of weight gain =10% of body weight 1 year ago among women and 10 years ago among men. Food insecurity without hunger among women associated with greater likelihood to gain >5kg of weight in 1 year. The third study estimated the probabilities of dyslipidemia and elevated plasma glucose (EPG) in relation to food insecurity among 2,572 men and 2,976 women. Results showed that, compared with the fully food secure, significantly higher percentage of marginally food secure women and food insecure without hunger women associated with dyslipidemia. Marginally food security and food insecurity without or with hunger among women associated with dyslipidemia. It was concluded that, among men, food insecurity without and with hunger associate with decreases in height, percent body fat and BMI. Among women, intermediate-level food insecurity associates with increased BMI, decreased height, greater weight gain and dyslipidemia. These results highlight the need to re-invigorate public health efforts towards improvement of food security and alleviate its effects both in the short and long term in the United States.